| Canoga Park Urgent Care Family Medicine | |
|
20905 Sherman Way Canoga Park CA 91303-1743 | |
| (818) 744-4369 | |
| (310) 444-0606 |
| Full Name | Canoga Park Urgent Care Family Medicine |
|---|---|
| Speciality | General Practice |
| Location | 20905 Sherman Way, Canoga Park, California |
| Authorized Official Name and Position | Syrus Feridouni (PRESIDENT) |
| Authorized Official Contact | 8187444369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canoga Park Urgent Care Family Medicine 20905 Sherman Way Canoga Park CA 91303-1743 Ph: (818) 744-4369 | Canoga Park Urgent Care Family Medicine 20905 Sherman Way Canoga Park CA 91303-1743 Ph: (818) 744-4369 |
| NPI Number | 1487913810 |
|---|---|
| Provider Enumeration Date | 05/04/2012 |
| Last Update Date | 10/22/2024 |
| Medicare PECOS PAC ID | 2961651203 |
|---|---|
| Medicare Enrollment ID | O20121002000647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487913810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A97912 (California) | Primary |
| 208D00000X | General Practice | A92103 (California) | Secondary |
| Provider Name | Syrus Feridouni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336271055 PECOS PAC ID: 8123110103 Enrollment ID: I20070822000831 |
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