| N/a | |
|
14124 Foothill Blvd Ste 100 Sylmar CA 91342-8051 | |
| (818) 486-8138 | |
| (818) 486-8138 |
| Full Name | N/a |
|---|---|
| Speciality | Internal Medicine |
| Location | 14124 Foothill Blvd Ste 100, Sylmar, California |
| Authorized Official Name and Position | Basem Fanous (CEO) |
| Authorized Official Contact | 8184868138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| N/a 20312 Howard Ct Woodland Hills CA 91364-5668 Ph: (818) 486-8138 | N/a 14124 Foothill Blvd Ste 100 Sylmar CA 91342-8051 Ph: (818) 486-8138 |
| NPI Number | 1730992009 |
|---|---|
| Provider Enumeration Date | 01/29/2025 |
| Last Update Date | 01/29/2025 |
| Certification Date | 01/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730992009 | NPI | - | NPPES |
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