| Mehboob Makhani Md A Professional Corporation | |
|
17075 Devonshire St Suite 204 Northridge CA 91325-1600 | |
| (818) 717-8464 | |
| (818) 530-7880 |
| Full Name | Mehboob Makhani Md A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 17075 Devonshire St, Northridge, California |
| Authorized Official Name and Position | Mehboob Makhani (PRESIDENT) |
| Authorized Official Contact | 8187178464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mehboob Makhani Md A Professional Corporation 20211 Via Medici Northridge CA 91326-4059 Ph: (818) 717-8464 | Mehboob Makhani Md A Professional Corporation 17075 Devonshire St Suite 204 Northridge CA 91325-1600 Ph: (818) 717-8464 |
| NPI Number | 1578835724 |
|---|---|
| Provider Enumeration Date | 02/03/2012 |
| Last Update Date | 10/03/2020 |
| Certification Date | 10/03/2020 |
| Medicare PECOS PAC ID | 9133387442 |
|---|---|
| Medicare Enrollment ID | O20120215000969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578835724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A64828 (California) | Primary |
| Provider Name | Mehboob A Makhani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386610988 PECOS PAC ID: 3375575962 Enrollment ID: I20050902000615 |
| Provider Name | Andre Alexandrian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407469554 PECOS PAC ID: 6103233960 Enrollment ID: I20210324001112 |
| Provider Name | Bose Mary Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134748932 PECOS PAC ID: 2668851684 Enrollment ID: I20220622002445 |
| Provider Name | Omobola O Fashola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801488192 PECOS PAC ID: 7416310479 Enrollment ID: I20230824001238 |
| Provider Name | Traci Allison Chamberlain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891357380 PECOS PAC ID: 8820434541 Enrollment ID: I20240315001466 |
| Provider Name | Paul Prettapapop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861899650 PECOS PAC ID: 1951748664 Enrollment ID: I20240318001051 |
| Provider Name | Moninderpal Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881469682 PECOS PAC ID: 8628417284 Enrollment ID: I20240415003574 |
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