Organization
ENCINO NEURODIAGNOSTIC CENTER
Active
Parent organization
F&M RADIOLOGY MEDICAL CENTER INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
F&M RADIOLOGY MEDICAL CENTER INC
Authorized official
DR. MOOSSA HEIKALI M.D (OWNER/MEDICAL DIRECTOR)
(818) 708-6163
Entity
Organization
Contact information
Practice address
16661 VENTURA BLVD, 226, ENCINO, CA 91436-1914
(818) 708-6163
(818) 708-6167
Mailing address
PO BOX 49911, LOS ANGELES, CA 90049-0911
(818) 708-6163
(818) 708-6167
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
A40559
CA
2084N0400X
Neurology Physician
Primary
A40559
CA
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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