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General NPI Number Information
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NPI Number | 1295598571
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Entity Type | Organization
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Legal Business Name | VIVA MED CENTER PC
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 17609 VENTURA BLVD STE 203
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City | ENCINO
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State | CA
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Zip | 91316-5121
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Country | US
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Telephone | 844-673-2600
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Fax | 844-673-2601
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Provider Business Mailing Address
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Address Line | 17609 VENTURA BLVD STE 203
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City | ENCINO
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State | CA
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Zip | 91316-5121
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Country | US
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Telephone | 844-673-2600
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Fax | 844-673-2601
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Authorized Official
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Title or Position | MEDICAL DIRECTOR, OWNER
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Name | BABAK SHABATIAN
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Credential | MD
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Telephone | 844-673-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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