| Primary Care Sports Medicine | |
|
18411 Clark St Ste 302 Tarzana CA 91356-3541 | |
| (818) 501-7276 | |
| Not Available |
| Full Name | Primary Care Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 18411 Clark St Ste 302, Tarzana, California |
| Authorized Official Name and Position | Byron Patterson (MEDICAL DIRECTOR) |
| 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 18411 Clark St Suite 302 Tarzana CA 91356-3506 Ph: (818) 501-7276 | Primary Care Sports Medicine 18411 Clark St Ste 302 Tarzana CA 91356-3541 Ph: (818) 501-7276 |
| NPI Number | 1134274418 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 06/28/2023 |
| Medicare PECOS PAC ID | 2365488723 |
|---|---|
| Medicare Enrollment ID | O20050707000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134274418 | NPI | - | NPPES |
| Provider Name | Byron O Patterson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1700859691 PECOS PAC ID: 7517903974 Enrollment ID: I20050715000629 |
| 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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