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Contact Information

ACT-LINE MEDICAL, INC., A PROFESSIONAL MEDICAL CORPORATION
16311 VENTURA BLVD STE 106
ENCINO, CA91436-2124
 Phone: 310-278-7000
 Fax: 310-321-4510
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for ACT-LINE MEDICAL, INC., A PROFESSIONAL MEDICAL CORPORATION

NPI Number 1790204139
LBN Legal business name ACT-LINE MEDICAL, INC., A PROFESSIONAL MEDICAL CORPORATION
Authorized official TOORAJ GRAVORI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/18/2017
Last updated 04/13/2023 - About 3 years ago
Identifiers
CA License # 14719
CA License # 75506
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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