Organization · NPI-2

Encino Neurodiagnostic Center

Psychiatry & Neurology, Neurology · Encino, CA

NPI number1235433657
StatusActive
Last updated in NPPESDec 28, 2010

Details

NPI
1235433657
Entity type
Organization (NPI-2)
Legal business name
Encino Neurodiagnostic Center
Organization subpart
Yes
Enumeration date
Dec 28, 2010
Last updated
Dec 28, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, NeurologyA40559CAYes
204C00000X Neuromusculoskeletal Medicine, Sports MedicineA40559CA

Practice location

16661 Ventura Blvd
226
Encino, CA 91436-1914

Phone 818-708-6163 · Fax 818-708-6167

Mailing address

Po Box 49911
Los Angeles, CA 90049-0911

Phone 818-708-6163 · Fax 818-708-6167

Authorized official

Moossa Heikali
Owner/Medical Director
8187086163

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