Organization
ENNEAGON HEALTH, APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYDIN POOLI MD (PRESIDENT AND CEO)
(310) 779-2289
Entity
Organization
Contact information
Practice address
12922 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606-2924
(310) 779-2289
Mailing address
12652 W SUNSET BLVD, LOS ANGELES, CA 90049-3831
(310) 779-2289
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
—
—
208800000X
Urology Physician
Primary
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
Other
Enumeration date
06/05/2019
Last updated
04/16/2024
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