Prohealth Physical Medicine
LBN: Boulevard Medical Group, Inc.
Prohealth Physical Medicine is an health care organization with primary practice located at 11239 Ventura Blvd Ste 213 , Studio City CA 91604-3167. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as the primary health care specialty.
Boulevard Medical Group, Inc. can be contacted via phone (818) 505-0152, or through Gonzalez, Robert via phone (818) 505-0152.
Contact Information
Primary practice address
11239 Ventura Blvd Ste 213
Studio City CA 91604-3167
Phone: (818) 505-0152
Fax: (818) 505-0398
Website:
Authorized official contact:
Name: Gonzalez, Robert Doctor of Chiropractic (DC)
Phone: (818) 505-0152
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X |
Profile Details
| NPI number | 1437551033 |
|---|---|
| LBN Legal business name | Boulevard Medical Group, Inc. |
| DBA Doing business as | Prohealth Physical Medicine |
| Authorized official | Gonzalez, Robert Doctor of Chiropractic (DC) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 25th, 2014 |
| Last updated | Oct 23rd, 2015 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437551033 | NPPES |
| California | Other | CB236695 | MEDICARE DME PTAN |
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