| Blue Lotus Medical Group | |
|
20315 Ventura Blvd Ste 315a Woodland Hills CA 91364-2449 | |
| (818) 481-1417 | |
| (505) 210-7275 |
| Full Name | Blue Lotus Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 20315 Ventura Blvd Ste 315a, Woodland Hills, California |
| Authorized Official Name and Position | Parichehr Tabibian (PRESIDENT & CEO) |
| Authorized Official Contact | 8184811417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Lotus Medical Group 4959 Doman Ave Tarzana CA 91356-4311 Ph: (818) 481-1417 | Blue Lotus Medical Group 20315 Ventura Blvd Ste 315a Woodland Hills CA 91364-2449 Ph: (818) 481-1417 |
| NPI Number | 1891332805 |
|---|---|
| Provider Enumeration Date | 12/09/2019 |
| Last Update Date | 04/20/2023 |
| Medicare PECOS PAC ID | 1658707385 |
|---|---|
| Medicare Enrollment ID | O20200128002896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891332805 | NPI | - | NPPES |
| Provider Name | Parichehr A Tabibian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154521730 PECOS PAC ID: 0345308110 Enrollment ID: I20081022000728 |
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