Healthcare Provider Details

I. General information

NPI: 1639715881
Provider Name (Legal Business Name): JFS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 VAN NUYS BLVD STE 112
VAN NUYS CA
91405-1972
US

IV. Provider business mailing address

7400 VAN NUYS BLVD STE 112
VAN NUYS CA
91405-1972
US

V. Phone/Fax

Practice location:
  • Phone: 818-483-4717
  • Fax: 818-483-4718
Mailing address:
  • Phone: 818-483-4717
  • Fax: 818-483-4718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH D SILVERSTEIN
Title or Position: PRESIDENT
Credential: PA-C
Phone: 818-483-4717