Organization
AXODERM CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE DAVOODY (OFFICE MANAGER / EXECUTIVE)
(818) 242-3200
Entity
Organization
Contact information
Practice address
1510 S CENTRAL AVE STE 640, GLENDALE, CA 91204-2552
(310) 933-5054
(310) 935-3367
Mailing address
1510 S CENTRAL AVE STE 640, GLENDALE, CA 91204-2552
(310) 933-5054
(310) 935-3367
Taxonomy
Speciality
Code
Description
License number
State
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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