Organization
MIORA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OZLEM EQUILS MD, FAAP (PRESIDENT, FOUNDER)
(310) 595-4094
Entity
Organization
Contact information
Practice address
4546 GRANGE ROAD, SANTA ROSA, CA 95404
(310) 595-4094
Mailing address
17328 VENTURA BLVD # 190, ENCINO, CA 91316-3904
(310) 595-4094
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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