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Organization
HEALTHYLIFE MG CORP
Active
Organization
HEALTHYLIFE MG CORP
Active
Other names
St Gianna Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MONESSA AZAD (CREDENTIALING)
(818) 361-5437
Entity
Organization
Contact information
Practice address
245 BERKSHIRE AVE, LA CANADA, CA 91011-4017
(818) 361-5437
Mailing address
245 BERKSHIRE AVE, LA CANADA, CA 91011-4017
(818) 361-5437
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/14/2024
Last updated
07/09/2024
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