Cisco Medical Group, INC
Clinic/Center, Primary Care in Burbank, CA. Organization (NPI-2).
NPI number1164097341
StatusActive
Last updated in NPPESJun 11, 2024
Details
- NPI
- 1164097341
- Entity type
- Organization (NPI-2)
- Legal business name
- Cisco Medical Group, INC
- Organization subpart
- No
- Enumeration date
- May 20, 2021
- Certification date
- Jun 11, 2024
- Last updated
- Jun 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
| 207R00000X | Internal Medicine | – | – | |
| 208D00000X | General Practice | – | – |
Other names
- Cisco Medical Group - Burbank (Doing Business As)
Practice location
290 E Verdugo Ave Ste 206Burbank, CA 91502-1342
Phone 818-757-0954 · Fax 818-757-0963
Mailing address
18518 Sherman WayReseda, CA 91335-4212
Phone 818-757-0954 · Fax 818-757-0963
Authorized official
Jose Francisco Martinez Cardenas
President/Medical Director
8187570954
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