Madatovian Medical Clinic, Inc. | |
501 W Glenoaks Blvd Ste 205 Glendale CA 91202-4042 | |
(818) 549-9630 | |
(818) 549-9631 |
Full Name | Madatovian Medical Clinic, Inc. |
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Speciality | Family Medicine |
Location | 501 W Glenoaks Blvd Ste 205, Glendale, California |
Authorized Official Name and Position | Vahan Madatovian (PHYSICIAN) |
Authorized Official Contact | 8185499630 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Madatovian Medical Clinic, Inc. 501 W Glenoaks Blvd Ste 205 Glendale CA 91202-4042 Ph: (818) 549-9630 | Madatovian Medical Clinic, Inc. 501 W Glenoaks Blvd Ste 205 Glendale CA 91202-4042 Ph: (818) 549-9630 |
NPI Number | 1134421050 |
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Provider Enumeration Date | 11/29/2010 |
Last Update Date | 11/30/2010 |
Medicare PECOS PAC ID | 3577744911 |
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Medicare Enrollment ID | O20110218000174 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134421050 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | A53748 (California) | Primary |
Provider Name | Vahan Madatovian |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1265650493 PECOS PAC ID: 6800836586 Enrollment ID: I20050512000279 |
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