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Organization

PROMINENT CARE GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN C LOGAN (PRESIDENT)
(818) 633-4153
Entity
Organization

Contact information

Practice address
11490 BURBANK BLVD, SUITE 6-C, N HOLLYWOOD, CA 91601-2389
(818) 633-4153
Mailing address
11490 BURBANK BLVD, SUITE 6-C, N HOLLYWOOD, CA 91601-2389

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G69486
CA

Other

Enumeration date
11/18/2008
Last updated
11/18/2008
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