Organization
MY NEW LIFE
Active
Other names
My New Life
Organization subpart
No
Provider details
NPI number
Authorized official
FOOJAN ZEINE (OWNER)
(818) 648-2140
Entity
Organization
Contact information
Practice address
5536 TAMPA AVE, TARZANA, CA 91356-3027
(818) 519-5940
Mailing address
5536 TAMPA AVE, TARZANA, CA 91356-3027
(818) 519-5940
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
190724AP
CA
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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