Sherman Oaks Pain and Spine Institute Inc

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A135166 Issued in CA

Legal business name

SHERMAN OAKS PAIN AND SPINE INSTITUTE INC

Practice address

4911 Van Nuys Blvd Ste 307
Sherman Oaks, CA 91403-1751

Phone

(818) 638-1159

NPI assigned

Sep 13, 2016

Organization subpart

No

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

Authorized official

Name

Yashar IlkhchouiNPI 1669799110

Title

Ceo, President

Phone

(818) 638-1159

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yashar Ilkhchoui, M.D.

  • Anesthesiology Physician
  • Santa Monica, CA
  • NPI 1669799110
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1447708987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 VISTA DEL MONTE AVE",
            "address_2": "APT. 206",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 VAN NUYS BLVD STE 307",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031751",
            "telephone_number": "818-638-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERMAN OAKS PAIN AND SPINE INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-13",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "ILKHCHOUI",
        "authorized_official_first_name": "YASHAR",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "818-638-1159"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A135166",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherman Oaks Medical GRP Inc
• Sherman Oaks Medical Supplies, Inc
• Sherman Oaks Mental Health Group
• Sherman Oaks Mental Health Group
• Sherman Oaks Mental Health Group GP
• Sherman Oaks Pain Center
• Sherman Oaks Pharmacy
• Sherman Oaks Pharmacy
• Sherman Oaks Surgery Center Inc. a Medical Corporation
• Sherman Oaks Urgent Care Clinic, Inc

• Interventional Pain Medicine Physician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.