Organization
ASSUTA FAMILY MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOROUSH ADAM RAMIN M.D. (PRESIDENT)
(818) 760-2800
Entity
Organization
Contact information
Practice address
12922 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606-2924
(818) 760-2800
(818) 760-7343
Mailing address
12922 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606-2924
(818) 760-2800
(818) 760-7343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A82603
CA
207R00000X
Internal Medicine Physician
A33650
CA
207V00000X
Obstetrics & Gynecology Physician
A41783
CA
208000000X
Pediatrics Physician
A42806
CA
2086X0206X
Surgical Oncology Physician
A60294
CA
208800000X
Urology Physician
A60294
CA
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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