| Sport Central Osteopathic, A Medical Corporation | |
|
8879 Laurel Canyon Blvd Suite C Sun Valley CA 91352-2959 | |
| (818) 252-2000 | |
| (818) 252-6896 |
| Full Name | Sport Central Osteopathic, A Medical Corporation |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 8879 Laurel Canyon Blvd, Sun Valley, California |
| Authorized Official Name and Position | Paul M Robinson (DIRECTOR) |
| Authorized Official Contact | 8189555112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sport Central Osteopathic, A Medical Corporation 14069 Marquesas Way Suite 216d Marina Del Rey CA 90292-6052 Ph: (310) 301-3031 | Sport Central Osteopathic, A Medical Corporation 8879 Laurel Canyon Blvd Suite C Sun Valley CA 91352-2959 Ph: (818) 252-2000 |
| NPI Number | 1144557729 |
|---|---|
| Provider Enumeration Date | 11/03/2009 |
| Last Update Date | 03/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144557729 | NPI | - | NPPES |
| 00G726000 | Other | CA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | G72600 (California) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | G72600 (California) | Primary |
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