| Moussa Faminini Md Inc | |
|
16661 Ventura Blvd Ste 818 Encino CA 91436-1999 | |
| (818) 501-3320 | |
| (818) 501-3414 |
| Full Name | Moussa Faminini Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 16661 Ventura Blvd Ste 818, Encino, California |
| Authorized Official Name and Position | Moussa Faminini (OWNER) |
| Authorized Official Contact | 8185013414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moussa Faminini Md Inc 16661 Ventura Blvd Ste 818 Encino CA 91436-1999 Ph: (818) 501-3320 | Moussa Faminini Md Inc 16661 Ventura Blvd Ste 818 Encino CA 91436-1999 Ph: (818) 501-3320 |
| NPI Number | 1952610941 |
|---|---|
| Provider Enumeration Date | 09/25/2010 |
| Last Update Date | 03/18/2011 |
| Medicare PECOS PAC ID | 6709901416 |
|---|---|
| Medicare Enrollment ID | O20100918000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952610941 | NPI | - | NPPES |
| 05D0726162 | Other | CA | CLIA |
| 00A3111340 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | A031134 (California) | Primary |
| Provider Name | Moussa Faminini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629084843 PECOS PAC ID: 7517082225 Enrollment ID: I20110321000177 |
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Prime Care Medical Solutions Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5535 Balboa Blvd Ste 104, Encino, CA 91316 Phone: 818-922-2140 | |
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Joel A Lebovitz Md A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16133 Ventura Blvd, Suite 400, Encino, CA 91436 Phone: 818-528-1025 Fax: 818-528-1026 |