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29229 Canwood St Ste 112 Agoura Hills CA 91301-1561 | |
| (818) 501-7276 | |
| (818) 501-7288 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Sports Medicine |
| Location | 29229 Canwood St Ste 112, Agoura Hills, California |
| Authorized Official Name and Position | Byron Patterson (CEO) |
| Authorized Official Contact | 8185017276 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
18411 Clark St Ste 302 Tarzana CA 91356-3541 Ph: (818) 501-7276 | 29229 Canwood St Ste 112 Agoura Hills CA 91301-1561 Ph: (818) 501-7276 |
| NPI Number | 1841977253 |
|---|---|
| Provider Enumeration Date | 06/28/2023 |
| Last Update Date | 12/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841977253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RS0010X | Internal Medicine - Sports Medicine | (* (Not Available)) | Primary |
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