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Organization
MEDGO
Active
Organization
MEDGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNIE KAZAROVA (OWNER)
(818) 200-2400
Entity
Organization
Contact information
Practice address
10025 SULLY DR, SUN VALLEY, CA 91352-4270
(818) 200-2400
(818) 450-0580
Mailing address
10025 SULLY DR, SUN VALLEY, CA 91352-4270
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/25/2026
Last updated
09/25/2026
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