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General NPI Number Information
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NPI Number | 1497426654
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Entity Type | Organization
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Legal Business Name | AMADA HEALTH GHALCHI
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 12424 WILSHIRE BLVD FL 12
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City | LOS ANGELES
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State | CA
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Zip | 90025-1052
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Country | US
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Telephone | 818-613-6789
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Fax |
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Provider Business Mailing Address
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Address Line | 820 N WHITTIER DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-3044
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | PARVIZ S SHOUR
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Credential |
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Telephone | 818-613-6789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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