| Dr. Elie Medical Center Internal Medicine & Cosmetics | |
|
17447 Chatsworth Street Granada Hills CA 91344 | |
| (818) 923-5702 | |
| (818) 923-5703 |
| Full Name | Dr. Elie Medical Center Internal Medicine & Cosmetics |
|---|---|
| Speciality | Internal Medicine |
| Location | 17447 Chatsworth Street, Granada Hills, California |
| Authorized Official Name and Position | Elaheh Farhadian (CEO) |
| Authorized Official Contact | 8189235702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Elie Medical Center Internal Medicine & Cosmetics 17447 Chatsworth Street Granada Hills CA 91344 Ph: (818) 923-5702 | Dr. Elie Medical Center Internal Medicine & Cosmetics 17447 Chatsworth Street Granada Hills CA 91344 Ph: (818) 923-5702 |
| NPI Number | 1922401215 |
|---|---|
| Provider Enumeration Date | 10/01/2014 |
| Last Update Date | 01/10/2019 |
| Medicare PECOS PAC ID | 3870817026 |
|---|---|
| Medicare Enrollment ID | O20150119000755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922401215 | NPI | - | NPPES |
| A100453 | Other | CA | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A100453 (California) | Primary |
| Provider Name | Elaheh Farhadian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316145956 PECOS PAC ID: 8527154582 Enrollment ID: I20071022000748 |
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