NPIMap

Organization Active NPI

Encino Neurodiagnostic Center

  • Neurology Physician
  • Encino, CA
National Provider Identifier
1235433657
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A40559 Issued in CA
Legal business name
ENCINO NEURODIAGNOSTIC CENTER
Practice address
16661 Ventura Blvd
226
Encino, CA 91436-1914
Phone
(818) 708-6163
Fax
(818) 708-6167
NPI assigned
Dec 28, 2010
Organization subpart
Yes
Parent organization
F&M RADIOLOGY MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Dr. Moossa Heikali, M.D
Title
Owner/Medical Director
Phone
(818) 708-6163

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204C00000X A40559 CA
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X A40559 CA Primary

Addresses

Primary practice location

16661 Ventura Blvd
226
Encino, CA 91436-1914

Mailing address

PO Box 49911
Los Angeles, CA 90049-0911
Phone (818) 708-6163

National Provider Directory

National Provider Directory
Tax ID family
F M Radiology Medical Center7 organizations share this tax ID, including this one
Part of
F M Radiology Medical Center

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1235433657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49911",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900490911",
            "telephone_number": "818-708-6163",
            "fax_number": "818-708-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD",
            "address_2": "226",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361914",
            "telephone_number": "818-708-6163",
            "fax_number": "818-708-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCINO NEURODIAGNOSTIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "F&M RADIOLOGY MEDICAL CENTER INC",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "HEIKALI",
        "authorized_official_first_name": "MOOSSA",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-708-6163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "A40559",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A40559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.