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General NPI Number Information
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NPI Number | 1386033371
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Entity Type | Organization
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Legal Business Name | ENCOMPASS PRIVATE CLINIC
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 7051 ALVARADO RD SUITE 101
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City | LA MESA
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State | CA
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Zip | 91942-8901
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Country | US
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Telephone | 619-460-7775
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Fax | 619-460-7023
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Provider Business Mailing Address
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Address Line | 7051 ALVARADO RD SUITE 101
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City | LA MESA
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State | CA
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Zip | 91942-8901
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Country | US
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Telephone | 619-460-7775
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Fax | 619-460-7023
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. ROBERT LAJVARDI
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Credential | MD
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Telephone | 619-460-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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