Healthcare Provider Details

I. General information

NPI: 1710893821
Provider Name (Legal Business Name): ST MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13226 MILLRACE ST
SUN VALLEY CA
91352-3717
US

IV. Provider business mailing address

13226 MILLRACE ST
SUN VALLEY CA
91352-3717
US

V. Phone/Fax

Practice location:
  • Phone: 213-308-9322
  • Fax:
Mailing address:
  • Phone: 213-308-9322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: HAKOP TATURYAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 818-395-3666