Organization · NPI-2

Functional Restoration

Psychiatry & Neurology, Pain Medicine · Encino, CA

NPI number1184810319

StatusActive

Last updated in NPPESOct 4, 2007

Details

NPI: 1184810319
Entity type: Organization (NPI-2)
Legal business name: Functional Restoration
Organization subpart: No
Enumeration date: Sep 21, 2007
Last updated: Oct 4, 2007

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2084P2900X	Psychiatry & Neurology, Pain Medicine	–	–	Yes
2084P0015X	Psychiatry & Neurology, Psychosomatic Medicine	–	–

Practice location

18065 Ventura Blvd
Encino, CA 91316-3517

Phone 818-708-6163 · Fax 818-708-6167

Mailing address

Po Box 491149
Los Angeles, CA 90049-9149

Phone 818-708-6163 · Fax 818-708-6167

Authorized official

Moosa Heikali
President/Medical Director
8187086163

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