# MIRACLE WOMEN'S MEDICAL GROUP INC

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

## Provider details

- **NPI number:** 1720217698
- **Authorized official:** MR. VON MOVASSAGHI (BILLING MANAGER)
- **Authorized official phone:** (949) 212-8339

## Contact information

- **Practice address:** 7100 VAN NUYS BLVD, SUITE 113, VAN NUYS, CA 91405-3063
- **Practice address phone:** (818) 909-0004
- **Practice address fax:** (818) 909-0008
- **Mailing address:** PO BOX 260185, ENCINO, CA 91426-0185
- **Mailing address phone:** (949) 212-8339
- **Mailing address fax:** (949) 502-8887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | A96648 | CA | Yes |

## Other

- **Enumeration date:** 07/13/2009
- **Last updated:** 12/20/2013