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General NPI Number Information
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NPI Number | 1831621127
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Entity Type | Organization
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Legal Business Name | OLIVE MEDICAL ASSOCIATES PC
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 358 E OLIVE AVE
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City | BURBANK
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State | CA
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Zip | 91502-1215
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Country | US
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Telephone | 818-561-4868
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Fax | 747-229-9288
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Provider Business Mailing Address
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Address Line | 358 E OLIVE AVE
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City | BURBANK
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State | CA
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Zip | 91502-1215
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Country | US
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Telephone | 818-561-4868
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALVA A MARSH
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Credential | MD
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Telephone | 818-561-4868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C22547
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License Number State | CA
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