Organization
TAVARUA MEDICAL REHABILITATION SERVICES
Active
Other names
TAVARUA MEDICAL & MENTAL SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
STAN SHARMA PHD (EXECUTIVE DIRECTOR)
(661) 254-6630
Entity
Organization
Contact information
Practice address
6265 SEPULVEDA BLVD, SUITE 10, VAN NUYS, CA 91411-1114
(818) 779-0555
(818) 779-0455
Mailing address
26460 SUMMIT CIR, SANTA CLARITA, CA 91350-2991
(661) 254-6630
(661) 254-6644
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
960000644
CA
261QP2300X
Primary Care Clinic/Center
Primary
960000644
CA
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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