Provider Demographics
NPI:1578744983
Name:FAMILY HEALTH CENTER & ACUPUNCTURE INC.
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTER & ACUPUNCTURE INC.
Other - Org Name:VALLEY FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:NOSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-902-9229
Mailing Address - Street 1:PO BOX 55361
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91413-0361
Mailing Address - Country:US
Mailing Address - Phone:818-902-9229
Mailing Address - Fax:818-902-9119
Practice Address - Street 1:5500 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-5127
Practice Address - Country:US
Practice Address - Phone:818-902-9229
Practice Address - Fax:818-902-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3324171100000X
CAA71543207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH71591Medicare UPIN