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Organization
MEDI MEDI COMMUNITY HEALTH CENTER
Active
Organization
MEDI MEDI COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY PISKOULIAN (FOUNDER /CEO)
(310) 200-7636
Entity
Organization
Contact information
Practice address
11900 AVALON BLVD STE 100, LOS ANGELES, CA 90061-2867
(323) 999-2838
Mailing address
348 E OLIVE AVE STE K, BURBANK, CA 91502-1250
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
183500000X
Pharmacist
—
NULL
183500000X
Pharmacist
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/06/2018
Last updated
12/19/2018
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