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NPI Code Detail

MEDICARE: VITALITY HEALTHCARE MEDICAL CORP

MEDICARE: VITALITY HEALTHCARE MEDICAL CORP
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
1111N00000XChiropractor
2225100000XPhysical Therapist
3171100000XAcupuncturist
4208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1245298256
Entity Type Code : Organization
Provider Name (Legal Business Name) : VITALITY HEALTHCARE MEDICAL CORP
Provider Business Mailing Address
First Line : 16500 VENTURA BLVD
Second Line : SUITE 414
City : ENCINO
State : CA
Zip : 91436-2011
Country : US
Telephone Number : 818-382-7880
Fax Number : 818-382-7886
Provider Business Practice Location Address
First Line : 16500 VENTURA BLVD
Second Line : SUITE 414
City : ENCINO
State : CA
Zip : 91436-2011
Country : US
Telephone Number : 818-382-7880
Fax Number : 818-382-7886
Authorized Official
Title or Position : CEO
Name : PEDRAM SHOJAI
Credential : LAC
Telephone Number : 818-382-7880
Provider Enumeration Date : 05/02/2006
Last Update Date : 01/09/2008

Similar Medicare Providers

1275886624 — SARAH MAY YOO M.S.
Practice Location Address:
16500 VENTURA BLVD , SUITE 414
ENCINO, CA
91436-2011
Practice Phone: 818-788-1003
Practice Fax:
1770968612 — GAYANE MARDYAN
Practice Location Address:
16500 VENTURA BLVD , 414
ENCINO, CA
91436-2011
Practice Phone: 818-788-1003
Practice Fax:
1689663395 — ROBERT E ENGSTROM JR. M.D.
Practice Location Address:
16500 VENTURA BLVD , SUITE 250
ENCINO, CA
91436-2011
Practice Phone: 818-788-9333
Practice Fax: 818-788-9273
1831188341 — SANDY Y. LEE M.D.
Practice Location Address:
16500 VENTURA BLVD , SUITE 250
ENCINO, CA
91436-2011
Practice Phone: 818-788-9333
Practice Fax: 818-788-9273
1912919820 — DR. MICHAEL STEPHEN REDER M.D.
Practice Location Address:
16500 VENTURA BLVD , SUITE 320
ENCINO, CA
91436-2011
Practice Phone: 818-986-1200
Practice Fax: 818-986-3011
1467465344 — MR. BIJAN DANESHGAR MD
Practice Location Address:
16500 VENTURA BLVD , STE 222
ENCINO, CA
91436-2011
Practice Phone: 818-905-6111
Practice Fax: 818-905-3250

Directions to “VITALITY HEALTHCARE MEDICAL CORP ” Practice Location

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