Organization
ACT-LINE MEDICAL, INC., A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOORAJ GRAVORI MD (PRESIDENT)
(310) 755-8333
Entity
Organization
Contact information
Practice address
16311 VENTURA BLVD STE 106, ENCINO, CA 91436-2124
(310) 278-7000
(310) 321-4510
Mailing address
16311 VENTURA BLVD STE 106, ENCINO, CA 91436-2124
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
75506
CA
208VP0000X
Pain Medicine Physician
14719
CA
Other
Enumeration date
09/18/2017
Last updated
04/13/2023
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