Provider Demographics
NPI:1851925663
Name:WEST CALIFORNIA MEDICAL CENTER APC
Entity Type:Organization
Organization Name:WEST CALIFORNIA MEDICAL CENTER APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSHABANAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-777-0192
Mailing Address - Street 1:9250 RESEDA BLVD # 121
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3142
Mailing Address - Country:US
Mailing Address - Phone:747-777-0192
Mailing Address - Fax:
Practice Address - Street 1:16661 VENTURA BLVD STE 213
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1940
Practice Address - Country:US
Practice Address - Phone:818-809-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-02
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch