Functional Restoration | |
18065 Ventura Blvd Encino CA 91316-3517 | |
(818) 708-6163 | |
(818) 708-6167 |
Full Name | Functional Restoration |
---|---|
Speciality | Psychiatry & Neurology - Pain Medicine |
Location | 18065 Ventura Blvd, Encino, California |
Authorized Official Name and Position | Moosa Heikali (PRESIDENT/MEDICAL DIRECTOR) |
Authorized Official Contact | 8187086163 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Functional Restoration Po Box 491149 Los Angeles CA 90049-9149 Ph: (818) 708-6163 | Functional Restoration 18065 Ventura Blvd Encino CA 91316-3517 Ph: (818) 708-6163 |
NPI Number | 1184810319 |
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Provider Enumeration Date | 09/21/2007 |
Last Update Date | 10/04/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184810319 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0015X | Psychiatry & Neurology - Psychosomatic Medicine | (* (Not Available)) | Secondary |
2084P2900X | Psychiatry & Neurology - Pain Medicine | (* (Not Available)) | Primary |
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