Provider Type Icon

101 FAMILY MEDICAL GROUPA PROFESSIONAL CORP NPI 1174856348


NPI Information

NPI: 1174856348
Provider Name: 101 FAMILY MEDICAL GROUP,A PROFESSIONAL CORP
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 05D2005248

Address:
22030 SHERMAN WAY STE 101
CANOGA PARK, CA
ZIP 91303
Phone: (818) 312-9101
Get Directions

101 FAMILY MEDICAL GROUP,A PROFESSIONAL CORP is a primary care clinic center in Canoga Park, CA. 101 FAMILY MEDICAL GROUP,A PROFESSIONAL CORP NPI is 1174856348. The provider is registered as an organization entity type.

The provider's business location address is:

22030 SHERMAN WAY STE 101
CANOGA PARK, CA
ZIP 91303-844
Phone: (818) 312-9101
Fax: (818) 312-9100

The provider's authorized official is Hessam Aazami .
The authorized official title is Medical Director and has the following contact phone number (818) 312-9101.

The CLIA number assigned to this NPI record is 05D2005248 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/6/2009 and was last updated on 4/7/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareA85704CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.