Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PORTER RANCH INTEGRATIVE MEDICAL CLINIC, A PROFESSIONAL CORPORATION
Active
Organization
PORTER RANCH INTEGRATIVE MEDICAL CLINIC, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNETT ANNAN ED.D. (GENERAL MANAGER)
(818) 831-8000
Entity
Organization
Contact information
Practice address
11177 TAMPA AVE, STE A, PORTER RANCH, CA 91326-2254
(818) 831-8000
(818) 831-8005
Mailing address
11177 TAMPA AVE, STE A, PORTER RANCH, CA 91326-2254
(818) 831-8000
(818) 831-8005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
111N00000X
Chiropractor
—
—
133V00000X
Registered Dietitian
—
—
171100000X
Acupuncturist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
08/08/2013
Last updated
08/08/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up