Cisco Medical Group, Inc

NPI 1053408989

Information of Cisco Medical Group, Inc

The NPI 1053408989 is an Organization type. NPI No 1053408989 belongs to Cisco Medical Group, Inc. Cisco Medical Group, Inc specializes in Pediatrics. is practising at 290 E Verdugo Ave, Burbank, California 91502. You can also contact him via phone number (818) 757-0954.

Practice address located

  • 290 E Verdugo Ave
  • Burbank, California 91502
  • (818) 757-0954
  • (818) 757-0954

Mailling address located

  • 18518 Sherman Way
  • Reseda, California 91335
  • (818) 757-0954
  • (818) 563-9578
Cisco Medical Group, Inc is PECOS enrolled.
NPI No 1053408989
Primary Taxonomy
Authorized Official
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
No208000000XPediatricsA86360California
Yes207R00000XInternal MedicineA81030California
Identifier for this provider
StateIdentifierTypeIssuer
CA05D1055441OtherCLIA
CAGR0103250Medicaidn/a
CAW16492Medicare PINn/a
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