| Primary Care Sports Medicine A Medical Corporation | |
|
29229 Canwood St Ste 112 Agoura Hills CA 91301-1561 | |
| (818) 501-7276 | |
| (818) 501-7288 |
| Full Name | Primary Care Sports Medicine A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 29229 Canwood St Ste 112, Agoura Hills, California |
| Authorized Official Name and Position | Byron Patterson (OWNER) |
| Authorized Official Contact | 8185017276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Sports Medicine A Medical Corporation 29229 Canwood St Ste 112 Agoura Hills CA 91301-1561 Ph: (818) 501-7276 | Primary Care Sports Medicine A Medical Corporation 29229 Canwood St Ste 112 Agoura Hills CA 91301-1561 Ph: (818) 501-7276 |
| NPI Number | 1134274418 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 02/19/2026 |
| Medicare PECOS PAC ID | 2365488723 |
|---|---|
| Medicare Enrollment ID | O20050707000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134274418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | A62510 (California) | Primary |
| Provider Name | Byron O Patterson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1700859691 PECOS PAC ID: 7517903974 Enrollment ID: I20050715000629 |
| Provider Name | Kristina J Miller |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689772154 PECOS PAC ID: 9537120886 Enrollment ID: I20061030000617 |
| Provider Name | Taryn N Moshiri |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033548656 PECOS PAC ID: 5092939587 Enrollment ID: I20140625000117 |
| Provider Name | Scott Freedman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922376607 PECOS PAC ID: 3476799081 Enrollment ID: I20140702002186 |
| Provider Name | Nina A Yaftali |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1881077592 PECOS PAC ID: 6204146855 Enrollment ID: I20151110002864 |
| Provider Name | Jonathan A Koretoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346668779 PECOS PAC ID: 9335448182 Enrollment ID: I20180912003407 |
| Provider Name | Haig Dadaian |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801433651 PECOS PAC ID: 0042647000 Enrollment ID: I20200304000550 |
| Provider Name | Michael Lino Peyton |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1487186318 PECOS PAC ID: 8527397264 Enrollment ID: I20210908003826 |
| Provider Name | Rachel Quan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134897507 PECOS PAC ID: 8628466810 Enrollment ID: I20211109002662 |
| Provider Name | Ernest Gyolchyan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275226524 PECOS PAC ID: 8921469206 Enrollment ID: I20230802003753 |
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Ruby C. Simpkins, M.d., A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 28240 Agoura Rd Ste 201, Agoura Hills, CA 91301 Phone: 818-991-9800 Fax: 818-991-9814 | |
Barry J Wallman Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29525 Can Wood St # 305, Agoura Hills, CA 91301 Phone: 818-707-7789 Fax: 818-707-7797 | |
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