Provider Demographics
NPI:1750713624
Name:OPTIMUM PERFORMANCE INSTITUTE, INC.
Entity type:Organization
Organization Name:OPTIMUM PERFORMANCE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-610-3956
Mailing Address - Street 1:5855 TOPANGA CANYON BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4675
Mailing Address - Country:US
Mailing Address - Phone:818-610-3956
Mailing Address - Fax:818-610-3912
Practice Address - Street 1:5855 TOPANGA CANYON BLVD STE 320
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-4675
Practice Address - Country:US
Practice Address - Phone:818-610-3956
Practice Address - Fax:818-610-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility