| Fidem Health Inc. | |
|
1342 San Luis Rey Dr Glendale CA 91208-1947 | |
| (323) 253-5821 | |
| Not Available |
| Full Name | Fidem Health Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1342 San Luis Rey Dr, Glendale, California |
| Authorized Official Name and Position | Manvel Kondradzhyan (CEO) |
| Authorized Official Contact | 3232535821 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fidem Health Inc. 1342 San Luis Rey Dr Glendale CA 91208-1947 Ph: (323) 253-5821 | Fidem Health Inc. 1342 San Luis Rey Dr Glendale CA 91208-1947 Ph: (323) 253-5821 |
| NPI Number | 1902552912 |
|---|---|
| Provider Enumeration Date | 02/28/2022 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/05/2024 |
| Medicare PECOS PAC ID | 2466991120 |
|---|---|
| Medicare Enrollment ID | O20240826002198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902552912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Manvel Kondradzhyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568988590 PECOS PAC ID: 4082975941 Enrollment ID: I20180311000001 |
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