Organization
FAMILY PRIMARY AND SPECIALTY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TAHERI MD (CEO)
(310) 922-1412
Entity
Organization
Contact information
Practice address
631 W AVENUE Q STE B, PALMDALE, CA 93551-3892
(661) 425-0295
Mailing address
PO BOX 16297, BEVERLY HILLS, CA 90209-2297
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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