| None | |
|
21041 Parthenia St Unit 158 Canoga Park CA 91304-2080 | |
| (818) 267-8479 | |
| (818) 450-0272 |
| Full Name | None |
|---|---|
| Speciality | Family Medicine |
| Location | 21041 Parthenia St Unit 158, Canoga Park, California |
| Authorized Official Name and Position | Petros Hajian (ADMINISTRATOR/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8182678479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 21041 Parthenia St Unit 158 Canoga Park CA 91304-2080 Ph: (818) 267-8479 | None 21041 Parthenia St Unit 158 Canoga Park CA 91304-2080 Ph: (818) 267-8479 |
| NPI Number | 1043850662 |
|---|---|
| Provider Enumeration Date | 01/11/2020 |
| Last Update Date | 12/09/2021 |
| Certification Date | 12/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043850662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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