MEDICARE: HIGHLAND DO INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1134445091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLAND DO INC

Provider Business Mailing Address
First Line	:	7251 OWENSMOUTH AVE
Second Line	:	SUITE 6
City	:	CANOGA PARK
State	:	CA
Zip	:	91303-1517
Country	:	US
Telephone Number	:	818-883-4100
Fax Number	:	818-883-4105

Provider Business Practice Location Address
First Line	:	7251 OWENSMOUTH AVE
Second Line	:	SUITE 6
City	:	CANOGA PARK
State	:	CA
Zip	:	91303-1517
Country	:	US
Telephone Number	:	818-883-4100
Fax Number	:	818-883-4105

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEREMY MOUNC
Credential	:
Telephone Number	:	818-883-4100

Provider Enumeration Date	:	04/15/2010
Last Update Date	:	04/15/2010

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