Provider Demographics
NPI:1467861914
Name:FRIST CHOICE HEALTHCARE MEDICAL GROUP,INC
Entity type:Organization
Organization Name:FRIST CHOICE HEALTHCARE MEDICAL GROUP,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMAYOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAEID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-376-0000
Mailing Address - Street 1:8215 VAN NUYS BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4839
Mailing Address - Country:US
Mailing Address - Phone:818-376-0000
Mailing Address - Fax:818-376-0576
Practice Address - Street 1:8215 VAN NUYS BLVD STE 306
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4839
Practice Address - Country:US
Practice Address - Phone:818-376-0000
Practice Address - Fax:818-376-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty