Healthcare Provider Details
I. General information
NPI: 1689214611
Provider Name (Legal Business Name): AALTO HYPERBARIC OXYGEN WOODLAND HILLS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2020
Last Update Date: 01/07/2020
Certification Date: 01/07/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23164 VENTURA BLVD STE C
WOODLAND HILLS CA
91364-1101
US
IV. Provider business mailing address
2080 CENTURY PARK E STE 200
LOS ANGELES CA
90067-2001
US
V. Phone/Fax
- Phone: 818-629-8988
- Fax: 818-914-5677
- Phone: 310-507-7942
- Fax: 310-507-7943
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0005X |
| Taxonomy | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ELISA
MARIA
MARSHALL
Title or Position: PRACTICE MANAGER
Credential:
Phone: 818-629-8988