| Pediatric Associates Medical Group, Inc. | |
|
4330 Fulton Ave Sherman Oaks CA 91423-3907 | |
| (818) 784-1102 | |
| (818) 784-1653 |
| Full Name | Pediatric Associates Medical Group, Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4330 Fulton Ave, Sherman Oaks, California |
| Authorized Official Name and Position | Thomas A Glassman (VICE PRESIDENT OF CORPORATION) |
| Authorized Official Contact | 8187841102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Associates Medical Group, Inc. 4330 Fulton Ave Sherman Oaks CA 91423-3907 Ph: (818) 784-1102 | Pediatric Associates Medical Group, Inc. 4330 Fulton Ave Sherman Oaks CA 91423-3907 Ph: (818) 784-1102 |
| NPI Number | 1255366712 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255366712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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