| Superclinic Professionals Medical Corp A California Corporation | |
|
12134 Victory Blvd North Hollywood CA 91606-3205 | |
| (818) 762-8702 | |
| (818) 761-2583 |
| Full Name | Superclinic Professionals Medical Corp A California Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 12134 Victory Blvd, North Hollywood, California |
| Authorized Official Name and Position | Mitchell Paul Rubin (ADMINISTRATOR) |
| Authorized Official Contact | 8187628702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Superclinic Professionals Medical Corp A California Corporation 12134 Victory Blvd North Hollywood CA 91606-3205 Ph: (818) 762-8702 | Superclinic Professionals Medical Corp A California Corporation 12134 Victory Blvd North Hollywood CA 91606-3205 Ph: (818) 762-8702 |
| NPI Number | 1326564212 |
|---|---|
| Provider Enumeration Date | 08/22/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6507120656 |
|---|---|
| Medicare Enrollment ID | O20180817001682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326564212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Herman Benjamin Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588789218 PECOS PAC ID: 3173437514 Enrollment ID: I20031118001132 |
| Provider Name | John Kowalczyk |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548254089 PECOS PAC ID: 0042273989 Enrollment ID: I20041110001255 |
| Provider Name | Archie R Mays |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568414886 PECOS PAC ID: 5991732943 Enrollment ID: I20050720001112 |
| Provider Name | John E Bohm |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992771604 PECOS PAC ID: 5991720112 Enrollment ID: I20060213000448 |
| Provider Name | Alejandro E Gil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417951963 PECOS PAC ID: 2961396726 Enrollment ID: I20100220000220 |
| Provider Name | Hossein Dehghani |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316156797 PECOS PAC ID: 6800995200 Enrollment ID: I20110215000300 |
| Provider Name | Victor W Shi |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1770857427 PECOS PAC ID: 3173758356 Enrollment ID: I20131023001742 |
| Provider Name | Aron Rotman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508900887 PECOS PAC ID: 7719878149 Enrollment ID: I20140603002596 |
| Provider Name | Elika Derek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427280510 PECOS PAC ID: 3577792365 Enrollment ID: I20141215001501 |
| Provider Name | Salar Hakham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386960854 PECOS PAC ID: 8022303411 Enrollment ID: I20160824001725 |
| Provider Name | Harout Dermendjian |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1689038424 PECOS PAC ID: 9537422852 Enrollment ID: I20180418001557 |
| Provider Name | Daniel Dermendjian |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1598262131 PECOS PAC ID: 2860729829 Enrollment ID: I20231101000748 |
Yaroslav A. Gofnung, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12660 Riverside Dr, Suite 225, North Hollywood, CA 91607 Phone: 818-487-0040 Fax: 818-487-0050 | |
Thesea Chinn Md Mph Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12660 Riverside Dr, Ste 110, North Hollywood, CA 91607 Phone: 818-766-2110 Fax: 818-508-1463 | |
Magna Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11755 Victory Blvd, Suite 206, North Hollywood, CA 91606 Phone: 818-762-9883 Fax: 818-762-3237 | |
Oxnard Medical Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12511 Oxnard St, North Hollywood, CA 91606 Phone: 818-762-2084 Fax: 818-762-2085 | |
Nhvc Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12826 Victory Blvd, Suite D, North Hollywood, CA 91606 Phone: 310-819-7059 | |
Shavash Safvati M D Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12626 Riverside Dr, Suite #303, North Hollywood, CA 91607 Phone: 818-760-2434 Fax: 818-760-8832 | |
Dmb Md Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7535 Laurel Canyon Blvd, North Hollywood, CA 91605 Phone: 818-962-5505 Fax: 811-821-6722 |