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NPI Code Detail

MEDICARE: LAUREL CANYON URGENCY MED GROUP

MEDICARE: LAUREL CANYON URGENCY MED GROUP
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
1207Q00000XFamily Medicine PhysicianA29900CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831387620
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAUREL CANYON URGENCY MED GROUP
Provider Business Mailing Address
First Line : 8020 LAUREL CANYON BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-1427
Country : US
Telephone Number : 818-767-9623
Fax Number :
Provider Business Practice Location Address
First Line : 8020 LAUREL CANYON BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-1427
Country : US
Telephone Number : 818-767-9623
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : AREG ALIKHANIAN
Credential :
Telephone Number : 818-247-3600
Provider Enumeration Date : 10/05/2007
Last Update Date : 10/05/2007

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Directions to “LAUREL CANYON URGENCY MED GROUP ” Practice Location

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