Organization
ELDORADO - VAN NUYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STAN SHARMA (PRESIDENT)
(661) 254-6630
Entity
Organization
Contact information
Practice address
6265 SEPULVEDA BLVD STE 9, VAN NUYS, CA 91411-1126
(818) 779-0555
(818) 779-0455
Mailing address
6265 SEPULVEDA BLVD STE 9, VAN NUYS, CA 91411-1114
(818) 779-0555
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
CA
Other
Enumeration date
08/02/2013
Last updated
08/19/2013
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