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Organization

MONA LISA MEDICAL GROUP, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALVA MARSH MD (CEO/MEDICAL DIRECTOR)
(747) 717-2993
Entity
Organization

Contact information

Practice address
14856 VANOWEN ST, VAN NUYS, CA 91405-3828
(747) 717-2993
Mailing address
14856 VANOWEN ST, VAN NUYS, CA 91405-3828
(747) 717-2993

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C22547
MEDICAL LICENSE
CA
Enumeration date
03/21/2022
Last updated
07/10/2025
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