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17701 Chatsworth St Granada Hills CA 91344-5604 | |
| (818) 363-3121 | |
| (818) 366-1728 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 17701 Chatsworth St, Granada Hills, California |
| Authorized Official Name and Position | Sekilar Rudra Sabaratnam (PRESIDENT) |
| Authorized Official Contact | 8183633121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17701 Chatsworth St Granada Hills CA 91344-5604 Ph: (818) 363-3121 | 17701 Chatsworth St Granada Hills CA 91344-5604 Ph: (818) 363-3121 |
| NPI Number | 1336206036 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336206036 | NPI | - | NPPES |
| GR0007030 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A29353 (* (Not Available)) | Primary |
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Gary John Lawson Md A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17447 Chatsworth St, Granada Hills, CA 91344 Phone: 818-360-1858 Fax: 818-360-4979 | |
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