| Healthcare Angels Medical Clinic, Inc. | |
|
9146 Sepulveda Blvd Ste B North Hills CA 91343-6948 | |
| (818) 920-1133 | |
| (818) 893-6030 |
| Full Name | Healthcare Angels Medical Clinic, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 9146 Sepulveda Blvd Ste B, North Hills, California |
| Authorized Official Name and Position | Ashkan Eliahou Sefaradi (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3105922522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthcare Angels Medical Clinic, Inc. 9146 Sepulveda Blvd Ste B North Hills CA 91343-6948 Ph: (818) 920-1133 | Healthcare Angels Medical Clinic, Inc. 9146 Sepulveda Blvd Ste B North Hills CA 91343-6948 Ph: (818) 920-1133 |
| NPI Number | 1720269194 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 12/05/2023 |
| Medicare PECOS PAC ID | 5890781728 |
|---|---|
| Medicare Enrollment ID | O20040423001391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720269194 | NPI | - | NPPES |
| 00A641830 | Medicaid | CA | |
| W17112 | Other | CA | MEDICARE GROUP ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A64183 (California) | Primary |
| Provider Name | Hosseingholi Ziaee |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477703569 PECOS PAC ID: 9537210885 Enrollment ID: I20090625000474 |
| Provider Name | Ashkan E Sefaradi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861802548 PECOS PAC ID: 8224383443 Enrollment ID: I20180612001445 |
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