Provider Demographics
NPI:1578820270
Name:QUALITY MEDICAL OPTIONS INC
Entity Type:Organization
Organization Name:QUALITY MEDICAL OPTIONS INC
Other - Org Name:QUALITY MEDICAL OPTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAHVASH
Authorized Official - Middle Name:
Authorized Official - Last Name:HERAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-710-7628
Mailing Address - Street 1:7218 VAN NUYS BLVD
Mailing Address - Street 2:D
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-6800
Mailing Address - Country:US
Mailing Address - Phone:310-710-7628
Mailing Address - Fax:
Practice Address - Street 1:7218 VAN NUYS BLVD
Practice Address - Street 2:D
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-6800
Practice Address - Country:US
Practice Address - Phone:310-710-7628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39992207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty