Provider Demographics
NPI:1962017269
Name:ONE PRIMARY CARE INC.
Entity Type:Organization
Organization Name:ONE PRIMARY CARE INC.
Other - Org Name:ONE PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSTAMLOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-230-5800
Mailing Address - Street 1:800 S CENTRAL AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-4388
Mailing Address - Country:US
Mailing Address - Phone:818-334-8440
Mailing Address - Fax:
Practice Address - Street 1:800 S CENTRAL AVE STE 210
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-4388
Practice Address - Country:US
Practice Address - Phone:818-334-8440
Practice Address - Fax:818-334-8441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty