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General NPI Number Information
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NPI Number | 1497122824
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Entity Type | Organization
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Legal Business Name | ANVAR MEDICAL GROUP
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 9346 CORBIN AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2405
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Country | US
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Telephone | 818-349-9966
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Fax | 818-349-5615
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Provider Business Mailing Address
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Address Line | 12021 WILSHIRE BLVD # 745
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City | LOS ANGELES
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State | CA
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Zip | 90025-1206
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Country | US
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Telephone | 818-349-9966
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Fax | 818-501-1892
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Authorized Official
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Title or Position | COO
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Name | MR. MICHAEL ANVAR
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Credential |
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Telephone | 818-349-9966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 543446
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License Number State | CA
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Taxonomy #2
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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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