Provider Demographics
NPI:1790242758
Name:LA MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:LA MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:APIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:818-696-2156
Mailing Address - Street 1:501 W GLENOAKS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-4045
Mailing Address - Country:US
Mailing Address - Phone:818-696-2156
Mailing Address - Fax:818-396-4448
Practice Address - Street 1:501 W GLENOAKS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-4045
Practice Address - Country:US
Practice Address - Phone:818-696-2156
Practice Address - Fax:818-396-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty