MIRACLE WOMEN'S MEDICAL GROUP INC NPI 1720217698

NPI Information

MIRACLE WOMEN'S MEDICAL GROUP INC is an obstetrics gynecology in Van Nuys, CA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. MIRACLE WOMEN'S MEDICAL GROUP INC NPI is 1720217698. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7100 VAN NUYS BLVD
SUITE 113
VAN NUYS, CA
ZIP 91405-063
Phone: (818) 909-0004
Fax: (818) 909-0008

The provider's authorized official is Von Movassaghi .
The authorized official title is Billing Manager and has the following contact phone number (949) 212-8339.

The CLIA number assigned to this NPI record is 05D2009118 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2009 and was last updated on 12/20/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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