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General NPI Number Information
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NPI Number | 1285515973
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Entity Type | Organization
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Legal Business Name | ENCINO SPINE & PAIN SURGERY CENTER
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 17000 VENTURA BLVD STE 101
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City | ENCINO
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State | CA
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Zip | 91316-4148
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Country | US
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Telephone | 855-906-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 17000 VENTURA BLVD STE 101
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City | ENCINO
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State | CA
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Zip | 91316-4148
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Country | US
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Telephone | 855-906-7246
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELENA SERDA
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Credential |
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Telephone | 661-472-4177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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