| Avicenna Medical Clinic | |
|
18445 Vanowen St Reseda CA 91335-5324 | |
| (818) 708-8484 | |
| Not Available |
| Full Name | Avicenna Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 18445 Vanowen St, Reseda, California |
| Authorized Official Name and Position | Aref Karbasi (PRESIDENT) |
| Authorized Official Contact | 8187088484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avicenna Medical Clinic 18445 Vanowen St Reseda CA 91335-5324 Ph: (818) 708-8484 | Avicenna Medical Clinic 18445 Vanowen St Reseda CA 91335-5324 Ph: (818) 708-8484 |
| NPI Number | 1295104313 |
|---|---|
| Provider Enumeration Date | 09/18/2015 |
| Last Update Date | 09/18/2015 |
| Medicare PECOS PAC ID | 4789993742 |
|---|---|
| Medicare Enrollment ID | O20151014002400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295104313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Aref K Karbasi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710208046 PECOS PAC ID: 9436385416 Enrollment ID: I20131121001011 |
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