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General NPI Number Information
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NPI Number | 1215729108
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Entity Type | Organization
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Legal Business Name | EVA MEDICAL CLINIC
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 16205 DEVONSHIRE ST STE B
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City | GRANADA HILLS
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State | CA
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Zip | 91344-6949
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Country | US
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Telephone | 818-472-9467
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Fax | 818-472-9467
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Provider Business Mailing Address
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Address Line | 16205 DEVONSHIRE ST STE B
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City | GRANADA HILLS
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State | CA
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Zip | 91344-6949
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Country | US
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Telephone | 818-488-1442
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Fax | 818-488-1443
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Authorized Official
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Title or Position | CEO
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Name | VARDGES KHACHATRYAN
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Credential |
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Telephone | 818-472-9467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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