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General NPI Number Information
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NPI Number | 1497828180
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Entity Type | Organization
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Legal Business Name | MID VALLEY PAIN CLINIC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 11550 INDIAN HILLS RD STE. 391
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City | MISSION HILLS
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State | CA
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Zip | 91345-1200
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Country | US
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Telephone | 310-440-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 11999 SAN VICENTE BLVD STE. 440
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City | LOS ANGELES
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State | CA
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Zip | 90049-5131
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Country | US
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Telephone | 310-440-3131
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABDALLAH ZAKI
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Credential | M.D.
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Telephone | 310-440-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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