NPI 1184810319

Functional Restoration

Organisation Pain Medicine (Psychiatry & Neurology) Physician Encino, CA

Practice location

Address: 18065 Ventura Blvd, Encino, CA 91316-3517
Phone: (818) 708-6163
Fax: (818) 708-6167
Mailing address: PO Box 491149, Los Angeles, CA 90049-9149

Authorised official

Name: Moosa Heikali
Title: President/Medical Director
Phone: (818) 708-6163

Registered specialties (2)

Pain Medicine (Psychiatry & Neurology) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P2900X

Other Psychiatry & Neurology providers in California →

Psychosomatic Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 2084P0015X

Registry record

NPI: 1184810319
Entity type: Organization
NPI issued: 21 Sep 2007
Record last updated: 4 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.