Provider Demographics
NPI:1477386464
Name:SENIOR CARE MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:SENIOR CARE MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTOVY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-709-4890
Mailing Address - Street 1:PO BOX 920970
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91392-0970
Mailing Address - Country:US
Mailing Address - Phone:310-709-4890
Mailing Address - Fax:818-361-4630
Practice Address - Street 1:501 N MACLAY AVE
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-2424
Practice Address - Country:US
Practice Address - Phone:310-709-4890
Practice Address - Fax:818-361-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty