Healthcare Provider Details

I. General information

NPI: 1457718298
Provider Name (Legal Business Name): SUNLAND MEDICAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8346 FOOTHILL BLVD
SUNLAND CA
91040-2849
US

IV. Provider business mailing address

8346 FOOTHILL BLVD
SUNLAND CA
91040-2849
US

V. Phone/Fax

Practice location:
  • Phone: 818-352-3888
  • Fax:
Mailing address:
  • Phone: 818-352-3888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA43573
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA43573
License Number StateCA

VIII. Authorized Official

Name: IRADJ NAZARIAN
Title or Position: PRESIDENT
Credential:
Phone: 818-352-3888