Provider Demographics
NPI:1215647623
Name:EUPNIC CORPORATION
Entity type:Organization
Organization Name:EUPNIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLYMANIJAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-995-7790
Mailing Address - Street 1:10573 W PICO BLVD # 224
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2333
Mailing Address - Country:US
Mailing Address - Phone:310-995-7790
Mailing Address - Fax:
Practice Address - Street 1:1920 N FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1623
Practice Address - Country:US
Practice Address - Phone:626-798-6777
Practice Address - Fax:626-798-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service