Atalla Medical Group | |
557 N Maclay Ave San Fernando CA 91340-2424 | |
(818) 639-0210 | |
Not Available |
Full Name | Atalla Medical Group |
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Speciality | Family Medicine |
Location | 557 N Maclay Ave, San Fernando, California |
Authorized Official Name and Position | Martha I Atalla (MD) |
Authorized Official Contact | 6309357306 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Atalla Medical Group 9839 Belmar Ave Northridge CA 91324-1655 Ph: (559) 804-3130 | Atalla Medical Group 557 N Maclay Ave San Fernando CA 91340-2424 Ph: (818) 639-0210 |
NPI Number | 1356963417 |
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Provider Enumeration Date | 05/12/2020 |
Last Update Date | 11/24/2020 |
Medicare PECOS PAC ID | 4284051327 |
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Medicare Enrollment ID | O20200903000777 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356963417 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Provider Name | Marta I Atalla |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1457687204 PECOS PAC ID: 5890822084 Enrollment ID: I20130620000603 |
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