Healthcare Provider Details
I. General information
NPI: 1962830539
Provider Name (Legal Business Name): MOTION PICTURE AND TELEVISION FUND
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2013
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23388 MULHOLLAND DR
WOODLAND HILLS CA
91364-2733
US
IV. Provider business mailing address
23388 MULHOLLAND DR
WOODLAND HILLS CA
91364-2733
US
V. Phone/Fax
- Phone: 818-876-1888
- Fax: 818-876-1298
- Phone: 818-876-1888
- Fax: 818-876-1298
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 283Q00000X |
| Taxonomy | Psychiatric Hospital |
| License Number | 930000109 |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
ROBERT
BEITCHER
Title or Position: CEO PRESIDENT
Credential:
Phone: 818-876-4155