Organization
FAMILY PRIMARY AND SPECIALTY CLINIC PC
Active
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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