| Functional Restoration Medical Center | |
|
18065 Ventura Blvd Encino CA 91316-3517 | |
| (818) 708-6163 | |
| (818) 708-6167 |
| Full Name | Functional Restoration Medical Center |
|---|---|
| Speciality | General Practice |
| Location | 18065 Ventura Blvd, Encino, California |
| Authorized Official Name and Position | Moossa 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 Medical Center Po Box 491149 Los Angeles CA 90049-9149 Ph: (818) 708-6163 | Functional Restoration Medical Center 18065 Ventura Blvd Encino CA 91316-3517 Ph: (818) 708-6163 |
| NPI Number | 1578758645 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 09/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578758645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A405591 (California) | Primary |
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