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ASSUTA FAMILY MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION NPI 1639400260


NPI Information

NPI: 1639400260
Provider Name: ASSUTA FAMILY MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D2148811

Address:
12922 VICTORY BLVD
NORTH HOLLYWOOD, CA
ZIP 91606
Phone: (818) 760-2800
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ASSUTA FAMILY MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION is a family medicine in North Hollywood, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ASSUTA FAMILY MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION NPI is 1639400260. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12922 VICTORY BLVD
NORTH HOLLYWOOD, CA
ZIP 91606-924
Phone: (818) 760-2800
Fax: (818) 760-7343

The provider's authorized official is Soroush Adam Ramin .
The authorized official title is President and has the following contact phone number (818) 760-2800.

The CLIA number assigned to this NPI record is 05D2148811 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/21/2010 and was last updated on 1/21/2010.


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
1207R00000XInternal MedicineA33650CALIFORNIANo
2207V00000XObstetrics & GynecologyA41783CALIFORNIANo
3208000000XPediatricsA42806CALIFORNIANo
42086X0206XSurgerySurgical OncologyA60294CALIFORNIANo
5208800000XUrologyA60294CALIFORNIANo
6207Q00000XFamily MedicineA82603CALIFORNIAYes

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

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