Provider Demographics
NPI:1821197070
Name:MEDRO MANAGEMEN COMAPNY INC.
Entity type:Organization
Organization Name:MEDRO MANAGEMEN COMAPNY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMAYOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-625-6642
Mailing Address - Street 1:832 GLENMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3204
Mailing Address - Country:US
Mailing Address - Phone:310-625-6642
Mailing Address - Fax:310-276-4795
Practice Address - Street 1:5455 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1807
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4201
Practice Address - Country:US
Practice Address - Phone:310-625-6642
Practice Address - Fax:310-276-4795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based