In-Line Medical, INC., A Professional Medical Corporation
Neurological Surgery in Encino, CA. Organization (NPI-2).
NPI number1982123329
StatusActive
Last updated in NPPESOct 24, 2019
Details
- NPI
- 1982123329
- Entity type
- Organization (NPI-2)
- Legal business name
- In-Line Medical, INC., A Professional Medical Corporation
- Organization subpart
- No
- Enumeration date
- Sep 18, 2017
- Last updated
- Oct 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207T00000X | Neurological Surgery | 75506 | CA | Yes |
| 208VP0000X | 14719 | CA |
Practice location
16311 Ventura Blvd Ste 1065-BEncino, CA 91436-2124
Phone 310-278-7000
Mailing address
16350 Ventura Blvd # D569Encino, CA 91436-5300
Phone 310-278-7000
Authorized official
Tooraj Gravori
President
3102787000
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