| Shalom Medical Corporation | |
|
1901 Broadview Dr Ste 355 Glendale CA 91208-1201 | |
| (818) 246-3306 | |
| (818) 246-3333 |
| Full Name | Shalom Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1901 Broadview Dr Ste 355, Glendale, California |
| Authorized Official Name and Position | David S Han (PRESIDENT) |
| Authorized Official Contact | 8182463306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom Medical Corporation 1560 E Chevy Chase Dr Suite 355 Glendale CA 91206-4197 Ph: (818) 246-3306 | Shalom Medical Corporation 1901 Broadview Dr Ste 355 Glendale CA 91208-1201 Ph: (818) 246-3306 |
| NPI Number | 1346343696 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 10/24/2019 |
| Medicare PECOS PAC ID | 3577564343 |
|---|---|
| Medicare Enrollment ID | O20070122000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346343696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A92286 (California) | Primary |
| Provider Name | David S Han |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093755977 PECOS PAC ID: 4385678119 Enrollment ID: I20050921000868 |
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