Healthcare Provider Details

I. General information

NPI: 1659453140
Provider Name (Legal Business Name): WOODLAND HILLS MEDICAL CLINIC II INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 TOPANGA CANYON BLVD
WOODLAND HILLS CA
91367-3623
US

IV. Provider business mailing address

5995 TOPANGA CANYON BLVD
WOODLAND HILLS CA
91367-3623
US

V. Phone/Fax

Practice location:
  • Phone: 818-340-3636
  • Fax: 818-340-9241
Mailing address:
  • Phone: 818-340-3636
  • Fax: 818-340-9241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. HAMID REZA MIRSHOJAE
Title or Position: OWNER
Credential: D.O.
Phone: 818-274-4609