Provider Demographics
NPI:1134445091
Name:HIGHLAND DO INC
Entity type:Organization
Organization Name:HIGHLAND DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-883-4100
Mailing Address - Street 1:7251 OWENSMOUTH AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1517
Mailing Address - Country:US
Mailing Address - Phone:818-883-4100
Mailing Address - Fax:818-883-4105
Practice Address - Street 1:7251 OWENSMOUTH AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1517
Practice Address - Country:US
Practice Address - Phone:818-883-4100
Practice Address - Fax:818-883-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty