Valley Village Health Clinic Pc | |
12626 Riverside Dr Ste 301 Valley Village CA 91607-3473 | |
(213) 385-0675 | |
(213) 365-6429 |
Full Name | Valley Village Health Clinic Pc |
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Speciality | Internal Medicine |
Location | 12626 Riverside Dr Ste 301, Valley Village, California |
Authorized Official Name and Position | Kristine Vardanyan (PROVIDER) |
Authorized Official Contact | 2133850675 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Valley Village Health Clinic Pc Po Box 27206 Los Angeles CA 90027-0206 Ph: (213) 385-0675 | Valley Village Health Clinic Pc 12626 Riverside Dr Ste 301 Valley Village CA 91607-3473 Ph: (213) 385-0675 |
NPI Number | 1881330603 |
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Provider Enumeration Date | 05/05/2022 |
Last Update Date | 05/05/2022 |
Medicare PECOS PAC ID | 4880076215 |
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Medicare Enrollment ID | O20220802002372 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881330603 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Jason E Groomer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619986965 PECOS PAC ID: 8729067582 Enrollment ID: I20040715000649 |
Provider Name | Liana Gevorkian |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902455215 PECOS PAC ID: 3779914809 Enrollment ID: I20200505002987 |
Provider Name | Kristine Vardanyan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972023778 PECOS PAC ID: 2062739170 Enrollment ID: I20200728001604 |
Provider Name | Aram Srapyan |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1033652607 PECOS PAC ID: 7517392798 Enrollment ID: I20200819003016 |
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