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Organization
INNOVATIVE PAIN AND SPINE PHYSICIANS
Active
Organization
INNOVATIVE PAIN AND SPINE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW S ROOT D.O. (AUTHORIZED OFFICIAL)
(818) 621-0019
Entity
Organization
Contact information
Practice address
4418 VINELAND AVE STE 218, NORTH HOLLYWOOD, CA 91602-2159
(818) 621-0019
Mailing address
4418 VINELAND AVE STE 218, NORTH HOLLYWOOD, CA 91602-2159
(818) 621-0019
(818) 671-5556
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
CA
Other
Enumeration date
11/15/2014
Last updated
09/29/2019
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