| Organization Name: | SPORT CENTRAL OSTEOPATHIC, A MEDICAL CORPORATION |
| NPI Number: | 1144557729 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL M ROBINSON (DIRECTOR) |
| Mailing Address: | 8879 Laurel Canyon Blvd Suite C Sun Valley |
| State: | CA US |
| Postal Code: | 913522959 |
| Phone Number: | 8182522000 |
| Fax Number: | 8182526896 |
| NPI Enumeration Date: | 11/03/2009 |
| NPI Last Update Date: | 03/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G72600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |