Organization
MIRACLE WOMEN'S MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VON MOVASSAGHI (BILLING MANAGER)
(949) 212-8339
Entity
Organization
Contact information
Practice address
7100 VAN NUYS BLVD, SUITE 113, VAN NUYS, CA 91405-3063
(818) 909-0004
(818) 909-0008
Mailing address
PO BOX 260185, ENCINO, CA 91426-0185
(949) 212-8339
(949) 502-8887
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A96648
CA
Other
Enumeration date
07/13/2009
Last updated
12/20/2013
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