MD NEURODIAGNOSTIC MGT SVCS (NPI# 1114478849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114478849 |
| Entity Type | Organization |
| Organization Name | MD NEURODIAGNOSTIC MGT SVCS |
| Practice Address |
2655 1st St Ste 250 Simi Valley CA 93065-1574 |
| Mailing Address |
Po Box 941715 Simi Valley CA 93094-1715 |
| Practice Telephone | 8186001572 |
| Practice Fax Number | 8777053046 |
| Mailing Telephone | 8186001572 |
| Mailing Fax Number | 8777053046 |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |
| Authorized Official Name | DR. JULIO CANTERO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8186001572 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
ME94218 | FL | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
CA129953 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 30990Z | 30990Z | 01 |
| Street Address |
2655 1ST ST STE 250 |
| City | SIMI VALLEY |
| State | CA |
| Zip Code | 93065-1574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992160121 | Ryan Eduardo Reyes | Specialist/Technologist, Other | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2015-12-14 |
| 1083074744 | Precise Neuro Management Service, Inc | Specialist/Technologist, Other | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2016-02-24 |
| 1255796926 | West Coast Neuromonitoring Inc | Psychiatry & Neurology | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2015-12-23 |
| 1447615117 | Precise Neuro Management Services, Inc | Psychiatry & Neurology | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2015-12-23 |
| 1700241478 | Premiere Neuromonitoring Inc | Psychiatry & Neurology | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2015-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992312243 | Healing Hands Health Care Corp | Hospice Care, Community Based | 585 E. Los Angeles Ave, Suite H-b, Simi Valley, CA 93065 | 2020-09-29 |
| 1487261731 | Healing Love Health Care Services, Inc. | Hospice Care, Community Based | 585 E. Los Angeles Ave., Suite H - A, Simi Valley, CA 93065 | 2020-09-29 |
| 1528682499 | Nicole G. Nalbandian | Dentist | First Street Dental Group and Orthodontics, 1197 E Los Angeles Ave Ste E, Simi Valley, CA 93065 | 2020-06-05 |
| 1316597230 | K-clear Nursing Inc | Family Medicine | 1822 Springgate Ln Unit G., Simi Valley, CA 93065 | 2019-09-12 |
| 1780242313 | Valencia Medical Inc | Family Medicine | 1526 Patricia Ave, Unit 159, Simi Valley, CA 93065 | 2019-05-29 |
| 1962920553 | Taylor Pediatrics | Pediatrics | 2755 Alamo Street Ste: 201, Simi Valley, CA 93065 | 2017-09-02 |
| 1487181301 | Renee Brooks | Marriage & Family Therapist | Ventura County Behavioral Health, 1227 E. Los Angeles Ave., Simi Valley, CA 93065 | 2017-05-23 |
| 1225577208 | Amanda Blake | Dietitian, Registered | 2592 Victoria St, Simi Valley, CA 93065 | 2017-02-23 |
| 1245778364 | Tyler James Arauza | Behavior Technician | 2856 Thicket Pl., Simi Valley, CA 93065 | 2017-02-09 |
| 1992169007 | Sahar Yaftaly | Dentist | 2045 Royal Ave Ste 109, Simi Valley, CA 93065 | 2016-04-06 |
| Find all providers in zip 93065 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700069630 | Tung Henry Tang | Psychiatry & Neurology | 2650 Jones Way Ste 30, Simi Valley, CA 93065-1221 | 2007-12-13 |
| 1255796926 | West Coast Neuromonitoring Inc | Psychiatry & Neurology | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2015-12-23 |
| 1447615117 | Precise Neuro Management Services, Inc | Psychiatry & Neurology | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2015-12-23 |
| 1700241478 | Premiere Neuromonitoring Inc | Psychiatry & Neurology | 2655 1st St Ste 250, Simi Valley, CA 93065-1574 | 2015-12-23 |
| 1346478567 | Jeffrey Ryan Mora | Psychiatry & Neurology | 2650 Jones Way Ste 30, Simi Valley, CA 93065-1221 | 2009-06-25 |
| 1053534610 | Peter K. Kim | Psychiatry & Neurology | 1195 Roadrunner Way, Simi Valley, CA 93065-0000 | 2007-04-11 |
| 1033296587 | Omid Rabbani | Psychiatry & Neurology | 2650 Jones Way, 30, Simi Valley, CA 93065-1221 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497352876 | Riverside Optimal Healthcare, Inc | Psychiatry & Neurology | 13320 Riverside Dr Ste 204, Sherman Oaks, CA 91423-2512 | 2020-10-08 |
| 1710592431 | Muhammad Amin | Psychiatry & Neurology | 33433 Pony Loop, Fremont, CA 94555-3511 | 2020-09-10 |
| 1558973792 | Catalyst Neuromedical Center PC | Psychiatry & Neurology | 3305 Placer St Ste B, Redding, CA 96001-2378 | 2020-08-19 |
| 1134730906 | West Coast Valley Medical Inc | Psychiatry & Neurology | 3357 Cahuenga Blvd W # 18, Los Angeles, CA 90068-1327 | 2020-08-13 |
| 1720603582 | Lily Wenya Zhou | Psychiatry & Neurology | 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 | 2020-06-08 |
| 1760015689 | Simon James Little | Psychiatry & Neurology | 1634 Divisadero St, Suite 250, San Francisco, CA 94115 | 2020-02-19 |
| 1427689256 | Alejandro F Centurion Md Inc | Psychiatry & Neurology | 100 Clock Tower Pl Ste 225, Carmel, CA 93923-8778 | 2020-01-30 |
| 1659901254 | Kern County Neurological Medical Group, Inc | Psychiatry & Neurology | 18645 Gale Ave Ste 228b, City of Industry, CA 91748-1363 | 2020-01-22 |
| 1609415314 | Aspire Holdings, Inc | Psychiatry & Neurology | 28212 Kelly Johnson Pkwy Ste 215, Valencia, CA 91355-5090 | 2019-12-27 |
| 1336785187 | Tp-health Ca PC | Psychiatry & Neurology | 201 E Center St Ste 112, Anaheim, CA 92805-7212 | 2019-11-26 |
| Find all providers with the same taxonomy | ||||
| City | SIMI VALLEY |
| Zip Code | 93065 |
Please comment or provide details below to improve the information on MD NEURODIAGNOSTIC MGT SVCS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.