| Total Health Elevated Medical Corp | |
|
17026 Devonshire St Northridge CA 91325-1617 | |
| (818) 488-9638 | |
| (818) 875-3228 |
| Full Name | Total Health Elevated Medical Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 17026 Devonshire St, Northridge, California |
| Authorized Official Name and Position | Nanotchka Chunley (OWNER) |
| Authorized Official Contact | 3105986020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Health Elevated Medical Corp 17026 Devonshire St Northridge CA 91325-1617 Ph: (818) 488-9638 | Total Health Elevated Medical Corp 17026 Devonshire St Northridge CA 91325-1617 Ph: (818) 488-9638 |
| NPI Number | 1699396754 |
|---|---|
| Provider Enumeration Date | 04/29/2020 |
| Last Update Date | 04/29/2020 |
| Medicare PECOS PAC ID | 9931518107 |
|---|---|
| Medicare Enrollment ID | O20210429002752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699396754 | NPI | - | NPPES |
| Provider Name | Andrea Anthony Kynard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316049620 PECOS PAC ID: 8921192139 Enrollment ID: I20070919000421 |
| Provider Name | Amanda Spino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750939526 PECOS PAC ID: 0547679714 Enrollment ID: I20210429002840 |
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