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General NPI Number Information
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NPI Number | 1982075107
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Entity Type | Organization
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Legal Business Name | PEDIATRIC AND FAMILY MEDICAL CENTER
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 15477 VENTURA BLVD SUITE 300
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3006
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Country | US
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Telephone | 213-747-5542
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Fax |
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Provider Business Mailing Address
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Address Line | 15477 VENTURA BLVD SUITE 300
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3006
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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 | SR VP, COO & INTERIM-CEO
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Name | MONICA MCCARTHY
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Credential |
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Telephone | 213-747-5542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | CA
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