Organization
SPIRIT MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS DZEBOLO (MEDICAL DIRECTOR)
(818) 245-6475
Entity
Organization
Contact information
Practice address
1030 S GLENDALE AVE STE 506, GLENDALE, CA 91205-2820
(818) 245-6475
(818) 245-6417
Mailing address
1030 S GLENDALE AVE STE 506, GLENDALE, CA 91205-2820
(818) 245-6475
(818) 245-6417
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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