Organization
HEALTH ATLAST WEST LA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE HIGASHI (PRESIDENT)
31039090108
Entity
Organization
Contact information
Practice address
14417 BURBANK BLVD, SHERMAN OAKS, CA 91401-4824
(818) 786-5985
Mailing address
3030 SAWTELLE BLVD, LOS ANGELES, CA 90066-1408
(310) 390-9018
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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