| Emmanuel Medical Clinic | |
|
7963 Van Nuys Blvd Ste 101 Panorama City CA 91402-6071 | |
| (818) 988-9818 | |
| (818) 988-9828 |
| Full Name | Emmanuel Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 7963 Van Nuys Blvd Ste 101, Panorama City, California |
| Authorized Official Name and Position | Sameh S Shenouda (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8189889818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emmanuel Medical Clinic 7963 Van Nuys Blvd Ste 101 Panorama City CA 91402-6071 Ph: (818) 983-7570 | Emmanuel Medical Clinic 7963 Van Nuys Blvd Ste 101 Panorama City CA 91402-6071 Ph: (818) 988-9818 |
| NPI Number | 1598270191 |
|---|---|
| Provider Enumeration Date | 12/06/2017 |
| Last Update Date | 07/09/2020 |
| Certification Date | 07/09/2020 |
| Medicare PECOS PAC ID | 4789943366 |
|---|---|
| Medicare Enrollment ID | O20180108001038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598270191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | A123234 (California) | Primary |
| Provider Name | Sameh S Shenouda |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487936902 PECOS PAC ID: 2365694551 Enrollment ID: I20121217000159 |
| Provider Name | George V Dous |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780936906 PECOS PAC ID: 5193006633 Enrollment ID: I20190809000704 |
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