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NPI Code Detail

MEDICARE: CANOGA PARK URGENT CARE FAMILY MEDICINE

MEDICARE: CANOGA PARK URGENT CARE FAMILY MEDICINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianA92103CA
2208D00000XGeneral Practice PhysicianA97912CA

General Provider Information

NPI Number : 1487913810
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANOGA PARK URGENT CARE FAMILY MEDICINE
Provider Business Mailing Address
First Line : 20905 SHERMAN WAY
Second Line :
City : CANOGA PARK
State : CA
Zip : 91303-1743
Country : US
Telephone Number : 818-744-4369
Fax Number : 310-444-0606
Provider Business Practice Location Address
First Line : 20905 SHERMAN WAY
Second Line :
City : CANOGA PARK
State : CA
Zip : 91303-1743
Country : US
Telephone Number : 818-744-4369
Fax Number : 310-444-0606
Authorized Official
Title or Position : PRESIDENT
Name : SYRUS FERIDOUNI
Credential : M.D.
Telephone Number : 818-744-4369
Provider Enumeration Date : 05/04/2012
Last Update Date : 10/22/2024

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Directions to “CANOGA PARK URGENT CARE FAMILY MEDICINE ” Practice Location

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