Organization
AMIGO INDUSTRIAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERE J MISSIRIAN MD (PRESIDENT)
(818) 759-2555
Entity
Organization
Contact information
Practice address
6801 COLDWATER CANYON AVE STE 1E, NORTH HOLLYWOOD, CA 91605-5167
(818) 759-2555
Mailing address
13029A VICTORY BLVD # 525, NORTH HOLLYWOOD, CA 91606-2925
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G84264
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
G84264
CA
208U00000X
Clinical Pharmacology Physician
G84264
CA
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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