| J & M Laurel Medical Center Inc | |
|
13680 Van Nuys Blvd Pacoima CA 91331-3616 | |
| (818) 897-7730 | |
| (818) 897-7831 |
| Full Name | J & M Laurel Medical Center Inc |
|---|---|
| Speciality | General Practice |
| Location | 13680 Van Nuys Blvd, Pacoima, California |
| Authorized Official Name and Position | Jahanbakhsh Nouri (PRESIDENT) |
| Authorized Official Contact | 8188977730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J & M Laurel Medical Center Inc 13680 Van Nuys Blvd Pacoima CA 91331-3616 Ph: (818) 897-7730 | J & M Laurel Medical Center Inc 13680 Van Nuys Blvd Pacoima CA 91331-3616 Ph: (818) 897-7730 |
| NPI Number | 1174120349 |
|---|---|
| Provider Enumeration Date | 10/01/2020 |
| Last Update Date | 10/01/2020 |
| Medicare PECOS PAC ID | 5395155253 |
|---|---|
| Medicare Enrollment ID | O20201104000262 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174120349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Manoutcher Khalili |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861446841 PECOS PAC ID: 1850337478 Enrollment ID: I20050706000259 |
| Provider Name | Jahanbakhsh Nouri |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366501629 PECOS PAC ID: 6305004474 Enrollment ID: I20120221000266 |
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