Healthcare Provider Details

I. General information

NPI: 1689486086
Provider Name (Legal Business Name): ALLIANZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17750 SHERMAN WAY STE 308
RESEDA CA
91335-3380
US

IV. Provider business mailing address

3951 MEDFORD ST
LOS ANGELES CA
90063-1608
US

V. Phone/Fax

Practice location:
  • Phone: 818-275-9470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ARTINE SAFARIAN
Title or Position: PRESIDENT
Credential:
Phone: 818-288-0571