Provider Demographics
NPI:1669610366
Name:WOODLAND HILLS ORTHOPEDICS AND SPORTS MEDICINE
Entity type:Organization
Organization Name:WOODLAND HILLS ORTHOPEDICS AND SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOFI
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHANDJYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-225-8444
Mailing Address - Street 1:23018 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1108
Mailing Address - Country:US
Mailing Address - Phone:818-225-8444
Mailing Address - Fax:818-591-2520
Practice Address - Street 1:23018 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1108
Practice Address - Country:US
Practice Address - Phone:818-225-8444
Practice Address - Fax:818-591-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77804111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty