Organization · NPI-2

Amen Clinics INC, La

Psychiatry & Neurology, Diagnostic Neuroimaging · Encino, CA

NPI number1871119982
StatusActive
Last updated in NPPESJun 24, 2020

Details

NPI
1871119982
Entity type
Organization (NPI-2)
Legal business name
Amen Clinics INC, La
Organization subpart
Yes
Enumeration date
Jun 24, 2020
Certification date
Jun 24, 2020
Last updated
Jun 24, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging––Yes

Practice location

5363 Balboa Blvd Ste 100
Encino, CA 91316-2802

Phone 818-479-4400 · Fax 818-305-3779

Mailing address

5363 Balboa Blvd Ste 100
Encino, CA 91316-2802

Phone 818-479-4400

Authorized official

Christina T Mccormick
Data Systems Specialist
7038804000

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