| Family Medicine Associates Of Northridge A Medical Group Inc | |
|
18350 Roscoe Blvd Suite 600 Northridge CA 91325 | |
| (818) 727-1515 | |
| (818) 727-7997 |
| Full Name | Family Medicine Associates Of Northridge A Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 18350 Roscoe Blvd, Northridge, California |
| Authorized Official Name and Position | Mehran Okhovat (PRESIDENT) |
| Authorized Official Contact | 8187271515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Associates Of Northridge A Medical Group Inc 18350 Roscoe Blvd Suite 600 Northridge CA 91325 Ph: (818) 727-1515 | Family Medicine Associates Of Northridge A Medical Group Inc 18350 Roscoe Blvd Suite 600 Northridge CA 91325 Ph: (818) 727-1515 |
| NPI Number | 1104984327 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 01/26/2011 |
| Medicare PECOS PAC ID | 0941236780 |
|---|---|
| Medicare Enrollment ID | O20050712001322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104984327 | NPI | - | NPPES |
| GR0061720 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mehran A Okhovat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508967167 PECOS PAC ID: 0446399505 Enrollment ID: I20091221000077 |
| Provider Name | Elizabeth P Eddy-bertrand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669573218 PECOS PAC ID: 7618016775 Enrollment ID: I20091221000095 |
| Provider Name | Ritoo Gagneja |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093966236 PECOS PAC ID: 5890823447 Enrollment ID: I20100503000509 |
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