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General NPI Number Information
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NPI Number | 1356963417
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Entity Type | Organization
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Legal Business Name | ATALLA MEDICAL GROUP
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 557 N MACLAY AVE
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City | SAN FERNANDO
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State | CA
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Zip | 91340-2424
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Country | US
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Telephone | 818-639-0210
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Fax |
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Provider Business Mailing Address
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Address Line | 9839 BELMAR AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-1655
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Country | US
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Telephone | 559-804-3130
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MARTHA I ATALLA
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Credential | MD
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Telephone | 630-935-7306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics 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 | 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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