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General NPI Number Information
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NPI Number | 1609754183
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Entity Type | Organization
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Legal Business Name | FORWARD UROLOGY MEDICAL GROUP APC
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Dates
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Enumeration Date | 08/23/2025
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Last Update Date | 08/23/2025
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Provider Practice Location Address
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Address Line | 2625 W ALAMEDA AVE STE 400
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City | BURBANK
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State | CA
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Zip | 91505-4817
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Country | US
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Telephone | 818-841-6055
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Fax | 818-841-1082
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Provider Business Mailing Address
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Address Line | 12922 VICTORY BLVD STE B
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-2924
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Country | US
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Telephone | 818-760-2800
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Fax | 818-760-7343
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Authorized Official
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Title or Position | MANAGER
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Name | NATARAJ CHANDRASEKHAR
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Credential |
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Telephone | 818-760-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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