Provider Demographics
NPI:1720578040
Name:IHEAL
Entity Type:Organization
Organization Name:IHEAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKISOVA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:323-828-5620
Mailing Address - Street 1:8135 GEYSER AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-1208
Mailing Address - Country:US
Mailing Address - Phone:323-828-5620
Mailing Address - Fax:
Practice Address - Street 1:8907 WILSHIRE BLVD STE 270
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1929
Practice Address - Country:US
Practice Address - Phone:323-828-5620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty