# ENCINO SPORTS MEDICINE GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053550293
- **Authorized official:** STEVEN KAYE MD (CEO)
- **Authorized official phone:** (818) 986-1210

## Contact information

- **Practice address:** 16500 VENTURA BLVD, 360, ENCINO, CA 91436-2011
- **Practice address phone:** (818) 986-1210
- **Practice address fax:** (818) 986-1029
- **Mailing address:** 16500 VENTURA BLVD, 360, ENCINO, CA 91436-2011
- **Mailing address phone:** (818) 986-1210
- **Mailing address fax:** (818) 986-1029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | DC28811 | CA | — |
| 207R00000X | Internal Medicine Physician | G7818 | CA | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | G29768 | CA | Yes |

## Other

- **Enumeration date:** 02/11/2009
- **Last updated:** 02/11/2009