Healthcare Provider Details

I. General information

NPI: 1932856382
Provider Name (Legal Business Name): TOTAL SPINE INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2022
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4849 VAN NUYS BLVD STE 203
SHERMAN OAKS CA
91403-2122
US

IV. Provider business mailing address

4849 VAN NUYS BLVD STE 203
SHERMAN OAKS CA
91403-2122
US

V. Phone/Fax

Practice location:
  • Phone: 818-616-4429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW FOX
Title or Position: PRESIDENT
Credential: MD
Phone: 916-548-0428