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General NPI Number Information
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NPI Number | 1659919660
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Entity Type | Organization
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Legal Business Name | THRIVE MEDICAL, INC.
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 18740 VENTURA BLVD STE 101
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City | TARZANA
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State | CA
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Zip | 91356-3366
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Country | US
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Telephone | 818-906-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 3847 WESTFALL DR
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City | ENCINO
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State | CA
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Zip | 91436-4157
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Country | US
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Telephone | 818-692-0023
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. HOOMAN JEFF NAZAR
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Credential | DO
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Telephone | 818-692-0023
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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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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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