Provider Demographics
NPI:1528594736
Name:ALUNA MEDICAL GROUP INC
Entity Type:Organization
Organization Name:ALUNA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHADUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-623-9171
Mailing Address - Street 1:16661 VENTURA BLVD
Mailing Address - Street 2:SUITE 824
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1914
Mailing Address - Country:US
Mailing Address - Phone:818-887-7273
Mailing Address - Fax:818-887-5222
Practice Address - Street 1:16661 VENTURA BLVD
Practice Address - Street 2:SUITE 824
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1914
Practice Address - Country:US
Practice Address - Phone:818-887-7273
Practice Address - Fax:818-887-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty