| Optimum Medical Group North | |
|
2258 Foothill Blvd Ste 200 La Canada CA 91011-1472 | |
| (954) 675-3257 | |
| Not Available |
| Full Name | Optimum Medical Group North |
|---|---|
| Speciality | Family Medicine |
| Location | 2258 Foothill Blvd Ste 200, La Canada, California |
| Authorized Official Name and Position | Nare Stepanyan (PARTNER) |
| Authorized Official Contact | 9546753257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Medical Group North 2258 Foothill Blvd Ste 200 La Canada CA 91011-1472 Ph: () - | Optimum Medical Group North 2258 Foothill Blvd Ste 200 La Canada CA 91011-1472 Ph: (954) 675-3257 |
| NPI Number | 1194498873 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 07/28/2021 |
| Medicare PECOS PAC ID | 5294132692 |
|---|---|
| Medicare Enrollment ID | O20210928002590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194498873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nare Stepanyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003386558 PECOS PAC ID: 1456698117 Enrollment ID: I20190204001354 |
| Provider Name | James Keller Wortham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528114410 PECOS PAC ID: 1557445822 Enrollment ID: I20210308001691 |
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