Healthcare Provider Details
I. General information
NPI: 1740142454
Provider Name (Legal Business Name): NQ HEALTH PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14435 HAMLIN ST STE 108
VAN NUYS CA
91401-6205
US
IV. Provider business mailing address
14435 HAMLIN ST STE 108
VAN NUYS CA
91401-6205
US
V. Phone/Fax
- Phone: 818-997-7117
- Fax: 818-997-0117
- Phone: 818-997-7117
- Fax: 818-997-0117
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELYSS
SAPON
Title or Position: CEO
Credential:
Phone: 818-997-7117