Provider Demographics
NPI:1801129333
Name:PRIMARY HEALTH CLINIC
Entity type:Organization
Organization Name:PRIMARY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ELHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMAT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-779-1447
Mailing Address - Street 1:16101 VENTURA BLVD
Mailing Address - Street 2:SUITE 343
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2500
Mailing Address - Country:US
Mailing Address - Phone:818-779-1447
Mailing Address - Fax:818-827-4748
Practice Address - Street 1:16101 VENTURA BLVD
Practice Address - Street 2:SUITE 343
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2500
Practice Address - Country:US
Practice Address - Phone:818-779-1447
Practice Address - Fax:818-827-4748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27494OtherELHAM NEMAT, D.C.
CADC31102OtherSARA ARAMIPOUR, D.C.