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Organization

SPINE INSTITUTE INC., A MEDICAL CORPORATION

Active
Other names
Valley Spine Center aka The Spine Institute at Miracle Mile
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LIZA LOGAN CASC (CHIEF OPERATING OFFICER)
(818) 993-2542
Entity
Organization

Contact information

Practice address
4849 VAN NUYS BLVD, SUITE 217, SHERMAN OAKS, CA 91403-2128
(818) 990-4100
(818) 990-4199
Mailing address
4849 VAN NUYS BLVD, SUITE 217, SHERMAN OAKS, CA 91403-2128
(818) 990-4100
(818) 990-4199

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
G68053
CA

Other

Enumeration date
01/09/2007
Last updated
01/23/2012
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