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General NPI Number Information
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NPI Number | 1801087341
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Entity Type | Organization
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Legal Business Name | LOS FELIZ ASSOCIATES MEDICAL GROUP INC.
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 3171 LOS FELIZ BLVD SUITE 206
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City | LOS ANGELES
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State | CA
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Zip | 90039-1527
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Country | US
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Telephone | 323-644-7440
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Fax | 323-644-7443
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Provider Business Mailing Address
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Address Line | 3171 LOS FELIZ BLVD SUITE 206
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City | LOS ANGELES
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State | CA
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Zip | 90039-1527
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Country | US
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Telephone | 323-644-7440
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Fax | 323-644-7443
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OMID NASSIM
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Credential | M.D.
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Telephone | 323-644-7440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number | A42975
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License Number State | CA
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