Healthcare Provider Details
I. General information
NPI: 1265378798
Provider Name (Legal Business Name): SPECIALTY PRO MEDICAL GROUP APC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14624 SHERMAN WAY
VAN NUYS CA
91405-2241
US
IV. Provider business mailing address
14624 SHERMAN WAY
VAN NUYS CA
91405-2241
US
V. Phone/Fax
- Phone: 747-355-7277
- Fax:
- Phone: 747-355-7277
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CALIN
S
ARIMIE
Title or Position: CEO
Credential: MD
Phone: 747-355-7277