| NPI | 1629861844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEVORK EKIMYAN Manager 818-939-6289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-05-28 |