| Snl Medical Center A Medical Corporation | |
|
7400 Van Nuys Blvd Ste 111 Van Nuys CA 91405-1972 | |
| (818) 616-4484 | |
| (818) 616-4494 |
| Full Name | Snl Medical Center A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 7400 Van Nuys Blvd Ste 111, Van Nuys, California |
| Authorized Official Name and Position | Michael K Jefferson (OWNER /CEO) |
| Authorized Official Contact | 8186164484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Snl Medical Center A Medical Corporation 7400 Van Nuys Blvd Ste 111 Van Nuys CA 91405-1972 Ph: (818) 616-6484 | Snl Medical Center A Medical Corporation 7400 Van Nuys Blvd Ste 111 Van Nuys CA 91405-1972 Ph: (818) 616-4484 |
| NPI Number | 1730819079 |
|---|---|
| Provider Enumeration Date | 06/10/2022 |
| Last Update Date | 06/10/2022 |
| Medicare PECOS PAC ID | 2668856550 |
|---|---|
| Medicare Enrollment ID | O20220825003755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730819079 | NPI | - | NPPES |
| G68903 | Other | CA | MEDICAL BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael K Jefferson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689649469 PECOS PAC ID: 5294734687 Enrollment ID: I20061212000703 |
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