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General NPI Number Information
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NPI Number | 1093514861
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Entity Type | Organization
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Legal Business Name | ERX MEDICAL GROUP INC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 14434 HAMLIN ST STE 2A
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City | VAN NUYS
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State | CA
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Zip | 91401-1461
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Country | US
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Telephone | 818-809-2444
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Fax | 818-809-2445
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Provider Business Mailing Address
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Address Line | 14434 HAMLIN ST STE 2A
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City | VAN NUYS
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State | CA
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Zip | 91401-1461
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Country | US
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Telephone | 818-809-2444
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Fax | 818-809-2445
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS SIMA DIANA MENTOSYAN
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Credential | NP
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Telephone | 818-809-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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