Executive Health Associates Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

EXECUTIVE HEALTH ASSOCIATES CORP

Practice address

19234 Vanowen St Ste B
Reseda, CA 91335-5000

Phone

(424) 249-9131

NPI assigned

Feb 16, 2022

Last updated

Feb 16, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Masiullah Noor

Title

Ceo

Phone

(424) 249-9131

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1821743006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19234 VANOWEN ST STE B",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19234 VANOWEN ST STE B",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355000",
            "telephone_number": "424-249-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE HEALTH ASSOCIATES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "NOOR",
        "authorized_official_first_name": "MASIULLAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-249-9131"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Reseda, CA
• Providers in Reseda, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.