Organization
SHERMAN OAKS PAIN AND SPINE INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YASHAR ILKHCHOUI (CEO, PRESIDENT)
(818) 638-1159
Entity
Organization
Contact information
Practice address
4911 VAN NUYS BLVD STE 307, SHERMAN OAKS, CA 91403-1751
(818) 638-1159
Mailing address
4533 VISTA DEL MONTE AVE, APT. 206, SHERMAN OAKS, CA 91403-3031
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
A135166
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
09/13/2016
Last updated
02/19/2020
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