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General NPI Number Information
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NPI Number | 1225573793
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Entity Type | Organization
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Legal Business Name | EOCCMED.COM
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 15332 ANTIOCH ST # 823
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3628
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Country | US
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Telephone | 310-804-2720
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Fax | 310-804-3956
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Provider Business Mailing Address
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Address Line | 15332 ANTIOCH ST # 823
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3628
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Country | US
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Telephone | 310-804-2720
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Fax | 310-804-3956
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Authorized Official
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Title or Position | PRESIDENT
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Name | BEHZAD EMAD
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Credential |
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Telephone | 310-721-6162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A055727
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License Number State | CA
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