PEDIATRIC ASSOCIATES MEDICAL GROUP INC. NPI 1255366712

NPI Information

PEDIATRIC ASSOCIATES MEDICAL GROUP, INC. is a primary care clinic center in Sherman Oaks, CA. PEDIATRIC ASSOCIATES MEDICAL GROUP, INC. NPI is 1255366712. The provider is registered as an organization entity type.

The provider's business location address is:

4330 FULTON AVE
SHERMAN OAKS, CA
ZIP 91423-907
Phone: (818) 784-1102
Fax: (818) 784-1653

The provider's authorized official is Thomas A Glassman .
The authorized official title is Vice President Of Corporation and has the following contact phone number (818) 784-1102.

The CLIA number assigned to this NPI record is 05D0560868 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/12/2006 and was last updated on 8/22/2020.

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:

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