Individual
DR. MADHU MODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17929 LAKE VISTA DR, ENCINO, CA 91316-4443
(818) 708-3620
Mailing address
17929 LAKE VISTA DR, ENCINO, CA 91316-4443
(818) 708-3620
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A30547
CA
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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