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NPI 1174816631

NPI 1174816631 : PINNACLE BRAINPAINT : CALABASAS, CA

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General NPI Number Information
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    NPI Number           |    1174816631
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    Entity Type          |    Organization 
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    Legal Business Name  |    PINNACLE BRAINPAINT 
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Dates
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    Enumeration Date     |    05/17/2011
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    Last Update Date     |    05/17/2011
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Provider Practice Location Address
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    Address Line         |    26066 MULHOLLAND HWY 
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    City                 |    CALABASAS
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    State                |    CA
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    Zip                  |    91302-1916
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    Country              |    US
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    Telephone            |    818-880-0299
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    26066 MULHOLLAND HWY 
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    City                 |    CALABASAS
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    State                |    CA
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    Zip                  |    91302-1916
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    Country              |    US
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    Telephone            |    818-880-0299
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     GARY  VERBOON 
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    Credential           |    
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    Telephone            |    818-880-0299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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