| Venus Specialty Medical Corporation | |
|
17075 Devonshire St Ste 208 Northridge CA 91325-5408 | |
| (818) 217-4351 | |
| (818) 217-4104 |
| Full Name | Venus Specialty Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 17075 Devonshire St Ste 208, Northridge, California |
| Authorized Official Name and Position | Fariba Javaherian (DOCTOR) |
| Authorized Official Contact | 8182174351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Venus Specialty Medical Corporation 17075 Devonshire St Ste 208 Northridge CA 91325-5408 Ph: (818) 217-4351 | Venus Specialty Medical Corporation 17075 Devonshire St Ste 208 Northridge CA 91325-5408 Ph: (818) 217-4351 |
| NPI Number | 1306038062 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 08/14/2019 |
| Medicare PECOS PAC ID | 9537101654 |
|---|---|
| Medicare Enrollment ID | O20050527000521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306038062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
| Provider Name | Fariba Javaherian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114088804 PECOS PAC ID: 4082677547 Enrollment ID: I20041105000985 |
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