Provider Demographics
NPI:1609312412
Name:PRIMECARE HEALTH CENTER INC.
Entity Type:Organization
Organization Name:PRIMECARE HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-855-4992
Mailing Address - Street 1:23823 VALENCIA BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-9509
Mailing Address - Country:US
Mailing Address - Phone:661-855-4992
Mailing Address - Fax:
Practice Address - Street 1:23823 VALENCIA BLVD STE 150
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-9509
Practice Address - Country:US
Practice Address - Phone:661-855-4992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78087207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA78087OtherMEDICAL LICENSE