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General NPI Number Information
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NPI Number | 1326829367
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Entity Type | Organization
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Legal Business Name | NOHO MEDICAL CENTER INC
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 12805 VICTORY BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3012
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Country | US
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Telephone | 213-293-2323
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Fax | 213-290-9191
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Provider Business Mailing Address
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Address Line | 12805 VICTORY BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3012
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Country | US
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Telephone | 213-293-2323
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Fax | 213-290-9191
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Authorized Official
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Title or Position | CEO
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Name | DR. EDWARD NANA OPOKU JR.
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Credential | MD
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Telephone | 323-974-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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