Encino Sports Medicine Group, Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

G29768 Issued in CA

Legal business name

ENCINO SPORTS MEDICINE GROUP, INC.

Practice address

16500 Ventura Blvd
360
Encino, CA 91436-2011

Phone

(818) 986-1210

Fax

(818) 986-1029

NPI assigned

Feb 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven Kaye, MD

Title

Ceo

Phone

(818) 986-1210

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1053550293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16500 VENTURA BLVD",
            "address_2": "360",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362011",
            "telephone_number": "818-986-1210",
            "fax_number": "818-986-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16500 VENTURA BLVD",
            "address_2": "360",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362011",
            "telephone_number": "818-986-1210",
            "fax_number": "818-986-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCINO SPORTS MEDICINE GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "KAYE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-986-1210",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "DC28811",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G7818",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G29768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Encino Plaza Surgical Center
• Encino Procare Medical Center PC
• Encino Recovery Center, Inc.
• Encino Recovery, Inc.
• Encino Spine & Pain Surgery Center
• Encino Surgery Center, Inc
• Encino Surgical Center LLC
• Encino Surgical Institute,a.M.C
• Encino Surgicenter a Medical Group
• Encino Terrace, LLC

• Physical Medicine & Rehabilitation Physician in Encino, CA
• Providers in Encino, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.