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General NPI Number Information
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NPI Number | 1760297964
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE CONSULTING A MEDICAL CORP
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 1100 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-1404
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Country | US
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Telephone | 310-666-1915
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-1404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PEDRAM KHORSANDI
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Credential |
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Telephone | 310-666-1916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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