Provider Demographics
NPI:1982032611
Name:WEST COAST SPINE INSTITUTE APC
Entity Type:Organization
Organization Name:WEST COAST SPINE INSTITUTE APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-855-2565
Mailing Address - Street 1:16530 VENTURA BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4554
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16530 VENTURA BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4554
Practice Address - Country:US
Practice Address - Phone:818-855-2565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85756305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service