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General NPI Number Information
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NPI Number | 1558992982
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Entity Type | Organization
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Legal Business Name | DR FUSCALDOS HEALTH AND WELLNESS CENTER INC
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 06/18/2020
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Provider Practice Location Address
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Address Line | 7537 LAUREL CANYON BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605
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Country | US
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Telephone | 818-858-0211
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Fax |
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Provider Business Mailing Address
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Address Line | 7537 LAUREL CANYON BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605
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Country | US
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Telephone | 818-962-5505
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | FRANCISCO B FUSCALDO
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Credential | MD
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Telephone | 818-858-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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