| Family Urgent Care & Industrial Medical Clinic, Inc. | |
|
16661 Ventura Blvd. Suite 108 Encino CA 91436-1902 | |
| (818) 808-2828 | |
| (818) 788-0386 |
| Full Name | Family Urgent Care & Industrial Medical Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 16661 Ventura Blvd., Encino, California |
| Authorized Official Name and Position | Bruce E Fishman (PRESIDENT/MEDICAL DIRECTOR) |
| Authorized Official Contact | 8188082828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Urgent Care & Industrial Medical Clinic, Inc. 16661 Ventura Blvd. Suite 108 Encino CA 91436-1902 Ph: (818) 808-2828 | Family Urgent Care & Industrial Medical Clinic, Inc. 16661 Ventura Blvd. Suite 108 Encino CA 91436-1902 Ph: (818) 808-2828 |
| NPI Number | 1275784324 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 08/27/2015 |
| Medicare PECOS PAC ID | 7315985496 |
|---|---|
| Medicare Enrollment ID | O20050419001427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275784324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | FNP24261 (California) | Primary |
| Provider Name | Bruce E Fishman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164587358 PECOS PAC ID: 8628116647 Enrollment ID: I20091112000281 |
| Provider Name | William Lenaburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871562496 PECOS PAC ID: 0143504167 Enrollment ID: I20170310000916 |
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