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General NPI Number Information
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NPI Number | 1730814823
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Entity Type | Organization
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Legal Business Name | PRIORITY MEDICAL CLINIC A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 5348 TOPANGA CANYON BLVD STE 204
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-1739
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Country | US
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Telephone | 747-888-3280
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Fax | 747-888-3281
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Provider Business Mailing Address
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Address Line | 5348 TOPANGA CANYON BLVD STE 204
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-1739
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Country | US
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Telephone | 747-888-3280
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Fax | 747-888-3281
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DANIEL ROSE
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Credential | MD
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Telephone | 747-888-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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