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Organization
SAN FERNANDO VALLEY PULMONARY MEDICAL GROUP, INC.
Active
Organization
SAN FERNANDO VALLEY PULMONARY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JENKINS ENCE M.D. (CORPORATE SECRETARY)
(818) 609-7536
Entity
Organization
Contact information
Practice address
18399 VENTURA BLVD, SUITE 245, TARZANA, CA 91356-4233
(818) 609-7536
(818) 344-9670
Mailing address
18399 VENTURA BLVD, SUITE 245, TARZANA, CA 91356-4233
(818) 609-7536
(818) 344-9670
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0001370
—
CA
Enumeration date
07/22/2006
Last updated
08/22/2020
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