| Max M Ghannadi Md Medical Corp | |
|
14103 Victory Blvd Suite 7 Van Nuys CA 91401 | |
| (818) 994-0000 | |
| (818) 988-2949 |
| Full Name | Max M Ghannadi Md Medical Corp |
|---|---|
| Speciality | General Practice |
| Location | 14103 Victory Blvd, Van Nuys, California |
| Authorized Official Name and Position | Max M Ghannadi (PRESIDENT) |
| Authorized Official Contact | 8189999096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Max M Ghannadi Md Medical Corp 23679 Calabasas Rd # 327 Calabasas CA 91302-1502 Ph: (818) 887-5515 | Max M Ghannadi Md Medical Corp 14103 Victory Blvd Suite 7 Van Nuys CA 91401 Ph: (818) 994-0000 |
| NPI Number | 1003050873 |
|---|---|
| Provider Enumeration Date | 04/24/2009 |
| Last Update Date | 10/04/2010 |
| Medicare PECOS PAC ID | 3577615699 |
|---|---|
| Medicare Enrollment ID | O20090720000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003050873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A102618 (California) | Primary |
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