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Organization
EVOLVE CONCIERGE
Active
Organization
EVOLVE CONCIERGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHRYAR YADEGAR MD (CEO)
(323) 363-6910
Entity
Organization
Contact information
Practice address
18356 CLARK ST STE 101, TARZANA, CA 91356-3502
(818) 978-7888
Mailing address
18399 VENTURA BLVD STE 245, TARZANA, CA 91356-6403
(818) 609-7536
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4788092
CA SECRETARY OF STATE
CA
Enumeration date
10/11/2021
Last updated
10/11/2021
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