Organization
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMIN DAVIDOFF MD (EXECUTIVE MEDICAL DIRECTOR)
(877) 608-0044
Entity
Organization
Contact information
Practice address
11668 SHERMAN WAY, N HOLLYWOOD, CA 91605-5831
(818) 503-6800
Mailing address
393 E WALNUT ST, 3RD FL PHR GROUP & PROVIDER ENROLLMENT, PASADENA, CA 91188-0001
(626) 405-7914
(626) 405-4600
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/01/2006
Last updated
05/27/2021
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