Provider Demographics
NPI:1487213682
Name:AVALIN HEALTH MEDICAL CORPORATION
Entity Type:Organization
Organization Name:AVALIN HEALTH MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-749-1155
Mailing Address - Street 1:5419 HOLLYWOOD BLVD STE C802
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-3480
Mailing Address - Country:US
Mailing Address - Phone:323-749-1155
Mailing Address - Fax:470-275-0806
Practice Address - Street 1:4849 VAN NUYS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2110
Practice Address - Country:US
Practice Address - Phone:818-784-5300
Practice Address - Fax:470-275-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty