Sam Mavis

NPI #1043738370 in Pacoima, California

Provider Information

NPI Number: 1043738370
Entity Type: Individual
Name: Sam Mavis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 7, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 12450 VAN NUYS BLVD
City: Pacoima
State: California
ZIP Code: 91331-1391
Phone: (818) 896-1161

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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