Healthcare Provider Details

I. General information

NPI: 1154863256
Provider Name (Legal Business Name): HIGHER DOCTOR'S INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19231 SHERMAN WAY UNIT 23
RESEDA CA
91335-3537
US

IV. Provider business mailing address

19231 SHERMAN WAY UNIT 23
RESEDA CA
91335-3537
US

V. Phone/Fax

Practice location:
  • Phone: 818-220-4898
  • Fax:
Mailing address:
  • Phone: 818-220-4898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA137892
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA137892
License Number StateCA

VIII. Authorized Official

Name: BORIS S ARUTYUNOV
Title or Position: INTERNAL MEDICINE
Credential: MD
Phone: 818-220-4898