| Immunity Center | |
|
2010 N Glenoaks Blvd Burbank CA 91504-2835 | |
| (818) 906-4404 | |
| Not Available |
| Full Name | Immunity Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2010 N Glenoaks Blvd, Burbank, California |
| Authorized Official Name and Position | Vilik Harutyunyan (ADMINISTRATOR) |
| Authorized Official Contact | 3237937452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Immunity Center 2010 N Glenoaks Blvd Burbank CA 91504-2835 Ph: (818) 906-4404 | Immunity Center 2010 N Glenoaks Blvd Burbank CA 91504-2835 Ph: (818) 906-4404 |
| NPI Number | 1992581110 |
|---|---|
| Provider Enumeration Date | 09/04/2023 |
| Last Update Date | 02/29/2024 |
| Medicare PECOS PAC ID | 5890133557 |
|---|---|
| Medicare Enrollment ID | O20240401003184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992581110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 302F00000X | Exclusive Provider Organization | (* (Not Available)) | Secondary |
| Provider Name | Joseph Van Hanovnikian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861811366 PECOS PAC ID: 4082974514 Enrollment ID: I20180201001421 |
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