Healthcare Provider Details

I. General information

NPI: 1730009523
Provider Name (Legal Business Name): MEDLIFE HEALTH CLINIC A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8905 GLENOAKS BLVD UNIT L
SUN VALLEY CA
91352-2087
US

IV. Provider business mailing address

8905 GLENOAKS BLVD UNIT L
SUN VALLEY CA
91352-2087
US

V. Phone/Fax

Practice location:
  • Phone: 818-394-9045
  • Fax: 818-394-9059
Mailing address:
  • Phone: 818-394-9045
  • Fax: 818-394-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALVA ALARIC MARSH
Title or Position: DIRECTOR
Credential:
Phone: 818-394-9045