| Avanti Home Doctors, Inc. | |
|
17050 Chatsworth St Ste 253 Granada Hills CA 91344-5897 | |
| (818) 437-5848 | |
| Not Available |
| Full Name | Avanti Home Doctors, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 17050 Chatsworth St Ste 253, Granada Hills, California |
| Authorized Official Name and Position | Wallace Tupas Goodwin (COORDINATOR) |
| Authorized Official Contact | 8184375848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avanti Home Doctors, Inc. 17050 Chatsworth St Ste 253 Granada Hills CA 91344-5897 Ph: () - | Avanti Home Doctors, Inc. 17050 Chatsworth St Ste 253 Granada Hills CA 91344-5897 Ph: (818) 437-5848 |
| NPI Number | 1225500945 |
|---|---|
| Provider Enumeration Date | 12/19/2018 |
| Last Update Date | 12/19/2018 |
| Medicare PECOS PAC ID | 6406194265 |
|---|---|
| Medicare Enrollment ID | O20190220003285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225500945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Joselito P Babaran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225072564 PECOS PAC ID: 0648184325 Enrollment ID: I20031117000742 |
| Provider Name | Adam B Sherman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457486060 PECOS PAC ID: 2466407663 Enrollment ID: I20050330000682 |
| Provider Name | Denise F Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578766366 PECOS PAC ID: 2264489137 Enrollment ID: I20050401000944 |
| Provider Name | Patricia N Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205996386 PECOS PAC ID: 9436213220 Enrollment ID: I20090122000400 |
| Provider Name | Hermilito Villar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710946009 PECOS PAC ID: 4486729720 Enrollment ID: I20120305000235 |
| Provider Name | Billy Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255725156 PECOS PAC ID: 4385954320 Enrollment ID: I20151104000381 |
| Provider Name | Grace Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487026050 PECOS PAC ID: 0244530517 Enrollment ID: I20151118002950 |
| Provider Name | Jagmohan Ghotra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689032815 PECOS PAC ID: 8325334741 Enrollment ID: I20160912001816 |
| Provider Name | Alvin Zantua Merilles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629421458 PECOS PAC ID: 8325327323 Enrollment ID: I20161115001948 |
| Provider Name | Alexandra Kirtchik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376093914 PECOS PAC ID: 2567742901 Enrollment ID: I20161201000537 |
| Provider Name | Jayendra Arvindlal Shah |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1730354879 PECOS PAC ID: 2365746310 Enrollment ID: I20180322000423 |
| Provider Name | Aristotle E Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932659695 PECOS PAC ID: 7618227018 Enrollment ID: I20190405001412 |
| Provider Name | David N Deppen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316406796 PECOS PAC ID: 1456694611 Enrollment ID: I20190510001360 |
| Provider Name | Sazia Malek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659919223 PECOS PAC ID: 5698196459 Enrollment ID: I20200602003167 |
| Provider Name | Sharnjeet Dosanjh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316330970 PECOS PAC ID: 2769804897 Enrollment ID: I20200618002531 |
| Provider Name | Adebukola E Olusanya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710441720 PECOS PAC ID: 1456730092 Enrollment ID: I20220628001255 |
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