| Clover Medical Corporation Inc | |
|
12134 Victory Blvd Suite C North Hollywood CA 91606-3205 | |
| (818) 762-8702 | |
| (818) 761-2583 |
| Full Name | Clover Medical Corporation Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 12134 Victory Blvd, North Hollywood, California |
| Authorized Official Name and Position | Mitch Rubin (PRESIDENT) |
| Authorized Official Contact | 8187628702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clover Medical Corporation Inc 12134 Victory Blvd Suite C North Hollywood CA 91606-3205 Ph: (818) 762-8702 | Clover Medical Corporation Inc 12134 Victory Blvd Suite C North Hollywood CA 91606-3205 Ph: (818) 762-8702 |
| NPI Number | 1326317595 |
|---|---|
| Provider Enumeration Date | 12/17/2011 |
| Last Update Date | 05/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326317595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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