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NPI Code Detail

MEDICARE: WOODLAND HILLS MEDICAL CLINIC II INC.

MEDICARE: WOODLAND HILLS MEDICAL CLINIC II 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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1659453140
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOODLAND HILLS MEDICAL CLINIC II INC.
Provider Business Mailing Address
First Line : 5995 TOPANGA CANYON BLVD
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3623
Country : US
Telephone Number : 818-340-3636
Fax Number : 818-340-9241
Provider Business Practice Location Address
First Line : 5995 TOPANGA CANYON BLVD
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-3623
Country : US
Telephone Number : 818-340-3636
Fax Number : 818-340-9241
Authorized Official
Title or Position : OWNER
Name : MR. HAMID REZA MIRSHOJAE
Credential : D.O.
Telephone Number : 818-274-4609
Provider Enumeration Date : 10/20/2006
Last Update Date : 02/18/2016

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