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General NPI Number Information
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NPI Number | 1689156275
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Entity Type | Organization
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Legal Business Name | ENDOCRINE SPECIALTY CONSULTANT INC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 4418 VINELAND AVE STE 102
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City | TOLUCA LAKE
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State | CA
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Zip | 91602-3457
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Country | US
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Telephone | 818-239-0299
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Fax | 818-514-2374
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Provider Business Mailing Address
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Address Line | 4418 VINELAND AVE STE 102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91602-3457
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Country | US
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Telephone | 818-239-0299
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Fax | 818-514-2374
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Authorized Official
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Title or Position | PRESIDENT
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Name | MINH MACH
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Credential | MD
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Telephone | 818-239-0299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | A55349
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License Number State | CA
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