Basic Information
Provider Information
NPI: 1093780900
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ECOFF
FirstName: STEVEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7001
Address2:  
City: TARZANA
State: CA
PostalCode: 913577001
CountryCode: US
TelephoneNumber: 8188887815
FaxNumber: 8187151722
Practice Location
Address1: 7230 MEDICAL CENTER DR
Address2: STE. #503
City: WEST HILLS
State: CA
PostalCode: 913071907
CountryCode: US
TelephoneNumber: 8187166255
FaxNumber: 8187166255
Other Information
ProviderEnumerationDate: 02/22/2006
LastUpdateDate: 01/08/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X20A5497CAY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X20A5497CAN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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