Provider Demographics
NPI:1801226022
Name:NNMD GROUP INC
Entity Type:Organization
Organization Name:NNMD GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAMIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:NERIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-760-8990
Mailing Address - Street 1:12826 VICTORY BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3013
Mailing Address - Country:US
Mailing Address - Phone:818-760-8990
Mailing Address - Fax:
Practice Address - Street 1:12826 VICTORY BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3013
Practice Address - Country:US
Practice Address - Phone:818-760-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 11989208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty