MEDICARE: NAIGAVA MEDICAL MANAGEMENT GROUP INC

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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1538959192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAIGAVA MEDICAL MANAGEMENT GROUP INC

Provider Business Mailing Address
First Line	:	517 E WILSON AVE STE 201
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-5902
Country	:	US
Telephone Number	:	424-768-0505
Fax Number	:

Provider Business Practice Location Address
First Line	:	517 E WILSON AVE STE 201
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-5902
Country	:	US
Telephone Number	:	424-768-0505
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NORRIS AVAK
Credential	:
Telephone Number	:	424-768-0505

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	03/12/2026

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