Henmed Group Inc | |
10916 Riverside Dr Toluca Lake CA 91602-2210 | |
(818) 488-6076 | |
(818) 210-0281 |
Full Name | Henmed Group Inc |
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Speciality | Family Medicine |
Location | 10916 Riverside Dr, Toluca Lake, California |
Authorized Official Name and Position | Henry Chih-yang Hung (MEDICAL DIRECTOR) |
Authorized Official Contact | 8184886076 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Henmed Group Inc 10916 Riverside Dr Toluca Lake CA 91602-2210 Ph: (818) 488-6076 | Henmed Group Inc 10916 Riverside Dr Toluca Lake CA 91602-2210 Ph: (818) 488-6076 |
NPI Number | 1962103952 |
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Provider Enumeration Date | 03/15/2023 |
Last Update Date | 04/27/2023 |
Medicare PECOS PAC ID | 7911364112 |
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Medicare Enrollment ID | O20230602001237 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962103952 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Antuan Kiley |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619140050 PECOS PAC ID: 4880798636 Enrollment ID: I20090512000450 |
Provider Name | Vladislav Melnichenko |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528348273 PECOS PAC ID: 3072784420 Enrollment ID: I20120130000845 |
Provider Name | Henry Chih-yang Hung |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1730593682 PECOS PAC ID: 3870863285 Enrollment ID: I20170718001976 |
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