| |
200 S California St Burbank CA 91505 | |
(818) 954-6900 | |
(818) 450-0840 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 200 S California St, Burbank, California |
Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | 200 S California St Burbank CA 91505 Ph: (818) 954-6900 |
NPI Number | 1669193736 |
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Provider Enumeration Date | 09/07/2022 |
Last Update Date | 03/30/2023 |
Identifier | Type | State | Issuer |
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1669193736 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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