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Organization
PROVISION MEDICAL GROUP INC
Active
Organization
PROVISION MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNAIDA SHAKHVALADYAN (CEO)
(661) 383-3477
Entity
Organization
Contact information
Practice address
19702 SKYVIEW CT, SANTA CLARITA, CA 91351-6900
(661) 383-3477
Mailing address
19702 SKYVIEW CT, SANTA CLARITA, CA 91351-6900
(661) 383-3477
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/08/2026
Last updated
09/08/2026
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