Provider Demographics
NPI:1801604103
Name:GMOMENTUM INC
Entity type:Organization
Organization Name:GMOMENTUM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GOARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:MINASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:323-420-7777
Mailing Address - Street 1:6235 MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-2919
Mailing Address - Country:US
Mailing Address - Phone:323-420-7777
Mailing Address - Fax:
Practice Address - Street 1:6235 MORSE AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-2919
Practice Address - Country:US
Practice Address - Phone:323-420-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty