Healthcare Provider Details

I. General information

NPI: 1346104726
Provider Name (Legal Business Name): PRO HEALING A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 WILLIS AVE UNIT 307
SHERMAN OAKS CA
91403-2606
US

IV. Provider business mailing address

4675 WILLIS AVE UNIT 307
SHERMAN OAKS CA
91403-2606
US

V. Phone/Fax

Practice location:
  • Phone: 818-339-5056
  • Fax:
Mailing address:
  • Phone: 818-339-5056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELIZABETH CHILIAN
Title or Position: PRACTICE OWNER
Credential:
Phone: 818-620-5692