# SPORT CENTRAL OSTEOPATHIC, A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sport-Central Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144557729
- **Authorized official:** PAUL M ROBINSON MD (DIRECTOR)
- **Authorized official phone:** (818) 955-5112

## Contact information

- **Practice address:** 8879 LAUREL CANYON BLVD, SUITE C, SUN VALLEY, CA 91352-2959
- **Practice address phone:** (818) 252-2000
- **Practice address fax:** (818) 252-6896
- **Mailing address:** 14069 MARQUESAS WAY, SUITE 216D, MARINA DEL REY, CA 90292-6052
- **Mailing address phone:** (310) 301-3031
- **Mailing address fax:** (310) 301-3001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | G72600 | CA | Yes |
| 208D00000X | General Practice Physician | G72600 | CA | — |

## Other

- **Enumeration date:** 11/03/2009
- **Last updated:** 03/27/2010