# DJAVAHERIAN MEDICAL PRACTICE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carbon Health Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902418700
- **Authorized official:** MARLEY PAGE (DIRECTOR)
- **Authorized official phone:** (417) 861-9739

## Contact information

- **Practice address:** 90 HAVEMEYER ST, BROOKLYN, NY 11211-3340
- **Practice address phone:** (415) 200-2133
- **Mailing address:** 55 PACIFIC AVE \# 101, SAN FRANCISCO, CA 94111-2009
- **Mailing address phone:** (415) 200-2133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QE0002X | Emergency Care Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2020
- **Last updated:** 06/24/2025