Medwise Medical Clinic, Inc | |
540 N Central Ave Suite 203 Glendale CA 91203-1916 | |
(818) 242-0500 | |
Not Available |
Full Name | Medwise Medical Clinic, Inc |
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Speciality | General Practice |
Location | 540 N Central Ave, Glendale, California |
Authorized Official Name and Position | Shaliman Eivazzadeh (OWNER) |
Authorized Official Contact | 8182420500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Medwise Medical Clinic, Inc Po Box 601 Glendale CA 91209-0601 Ph: (818) 242-0500 | Medwise Medical Clinic, Inc 540 N Central Ave Suite 203 Glendale CA 91203-1916 Ph: (818) 242-0500 |
NPI Number | 1609813096 |
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Provider Enumeration Date | 06/02/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609813096 | NPI | - | NPPES |
00A420721 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | A42072 (California) | Primary |
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