| Comprehensive Infectious Disease Consultants A Medical Corporation | |
|
18370 Burbank Blvd Ste 414 Tarzana CA 91356-2804 | |
| (818) 506-3384 | |
| (818) 699-1278 |
| Full Name | Comprehensive Infectious Disease Consultants A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 18370 Burbank Blvd, Tarzana, California |
| Authorized Official Name and Position | Aaron Shelub (PRESIDENT) |
| Authorized Official Contact | 8185063384 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Infectious Disease Consultants A Medical Corporation Po Box 572770 Suite 415 Tarzana CA 91357-2770 Ph: (818) 506-3384 | Comprehensive Infectious Disease Consultants A Medical Corporation 18370 Burbank Blvd Ste 414 Tarzana CA 91356-2804 Ph: (818) 506-3384 |
| NPI Number | 1063886166 |
|---|---|
| Provider Enumeration Date | 11/30/2015 |
| Last Update Date | 10/28/2016 |
| Medicare PECOS PAC ID | 0749582641 |
|---|---|
| Medicare Enrollment ID | O20160108002577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063886166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Aaron M Shelub |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124103619 PECOS PAC ID: 0143382291 Enrollment ID: I20081223000679 |
| Provider Name | Yoko Miyasaki |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497845036 PECOS PAC ID: 3779622634 Enrollment ID: I20091207000085 |
| Provider Name | Judeen Camacho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881749208 PECOS PAC ID: 0941434013 Enrollment ID: I20131002000544 |
| Provider Name | Marian N Serunjogi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376898833 PECOS PAC ID: 8022336684 Enrollment ID: I20150410000006 |
| Provider Name | Emily L Alexiadis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891297073 PECOS PAC ID: 3173955648 Enrollment ID: I20191121002131 |
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