Provider Demographics
NPI:1356745194
Name:WOODLAND HILLS MEDICAL CLINIC II INC
Entity type:Organization
Organization Name:WOODLAND HILLS MEDICAL CLINIC II INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRSHOJAE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-340-3636
Mailing Address - Street 1:5995 TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3623
Mailing Address - Country:US
Mailing Address - Phone:818-888-7009
Mailing Address - Fax:
Practice Address - Street 1:5995 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3623
Practice Address - Country:US
Practice Address - Phone:818-888-7009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG17940Medicare UPIN