Organization
SEPULVEDA OPTIMAL HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAVEH KARANDISH MD (CEO/OWNER)
(818) 836-0608
Entity
Organization
Contact information
Practice address
15243 VANOWEN ST STE 403, VAN NUYS, CA 91405-3611
(818) 836-0608
Mailing address
15243 VANOWEN ST STE 403, VAN NUYS, CA 91405-3611
(818) 836-0608
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C168905
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
12/14/2021
Last updated
04/21/2022
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