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General NPI Number Information
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NPI Number | 1083427561
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Entity Type | Organization
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Legal Business Name | AMD IOP LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 10736 BURBANK BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-2516
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Country | US
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Telephone | 818-275-9810
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Fax | 907-313-1400
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Provider Business Mailing Address
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Address Line | 10736 BURBANK BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-2516
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Country | US
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Telephone | 818-275-9810
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MIKE BERBERIAN
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Credential |
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Telephone | 310-977-7080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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