Provider Demographics
NPI:1508004656
Name:EAST VALLEY PANORAMA, INC.
Entity Type:Organization
Organization Name:EAST VALLEY PANORAMA, INC.
Other - Org Name:PANORAMA HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:818-894-4910
Mailing Address - Street 1:8608 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-2913
Mailing Address - Country:US
Mailing Address - Phone:818-894-4910
Mailing Address - Fax:818-894-4913
Practice Address - Street 1:8608 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-2913
Practice Address - Country:US
Practice Address - Phone:818-894-4910
Practice Address - Fax:818-894-4913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder