Organization
FMC 26, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOABB MARIE GRIPPO (BILLING MANAGER)
(909) 967-5670
Entity
Organization
Contact information
Practice address
14547 VICTORY BLVD, VAN NUYS, CA 91411-1619
(818) 997-3232
(818) 997-7750
Mailing address
14547 VICTORY BLVD, VAN NUYS, CA 91411-1619
(818) 997-3232
(818) 997-7750
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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