QUALITY NEURO SUPPLY LLC (NPI# 1144564477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144564477 |
| Entity Type | Organization |
| Organization Name | QUALITY NEURO SUPPLY LLC |
| Other Organization Name | QUALITY NEUROMONITORING |
| Practice Address |
2201 W Broadway Suite B201 Anaheim CA 92804-2374 |
| Mailing Address |
Po Box 2864 Anaheim CA 92814-0864 |
| Practice Telephone | 8186001572 |
| Practice Fax Number | 8776257254 |
| Mailing Telephone | 8186001572 |
| Mailing Fax Number | 8776257254 |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |
| Authorized Official Name | JULIO CANTERO (MANAGING PARTNER) |
| Authorized Official Telephone | 8186001572 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
2124 | TX | Technologists, Technicians & Other Technical Service Providers |
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
ME94218 | FL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| QUALITY NEUROMONITORING | Doing Business As Name - Organization |
| Street Address |
2201 W BROADWAY SUITE B201 |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92804-2374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225372550 | Accurate Diagnostic & Management Services | Psychiatry & Neurology | 2201 W Broadway, Suite B201, Anaheim, CA 92804-2374 | 2012-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811517261 | Crown Care Hospice Inc | Hospice Care, Community Based | 10568 Magnolia Ave., Suite106, Stanton, CA 92804 | 2020-04-24 |
| 1154971646 | Leita Pawline Lawrene | Technician | 900 S Beach Blvd # 132, Anaheim, CA 92804 | 2019-09-17 |
| 1942767611 | Yasmen Abuyousef | Behavior Technician | 714 W Commonweath Ave, Suite C, Fullerton, CA 92804 | 2019-02-28 |
| 1225501224 | Brandon Pourazima | Physician Assistant | 631 S Brookhurst St Ste 213b, Anaheim, CA 92804 | 2019-01-02 |
| 1043782576 | Origins Home Health Care Inc. | Home Health | 137 1/2 S So Knott, Anaheim, CA 92804 | 2018-12-21 |
| 1346762150 | Inhee Shinn | Acupuncturist | 1717 W. Ball Road., Anaheim, CA 92804 | 2017-07-13 |
| 1689122459 | Jayanthi Ravikumar Md Inc | Physical Medicine & Rehabilitation | 3356 W Ball Road, #216, Anaheim, CA 92804 | 2016-09-21 |
| 1215307954 | Tuan Manh Hoang | Dentist | 1317 S. Courtright Street, Anaheim, CA 92804 | 2015-10-06 |
| 1598101602 | Optimal Sleep Center | Clinical Medical Laboratory | 3340 West Ball Road Suite B, Anaheim, CA 92804 | 2013-05-15 |
| 1376885673 | Michelle Lananh Dang | Pharmacist | 1913 W. Elm Pl, Anaheim, CA 92804 | 2013-03-25 |
| Find all providers in zip 92804 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
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| 1316560378 | Green Flash Physician Oversight PC | Psychiatry & Neurology | 2868 Bayside Walk Unit C, San Diego, CA 92109-8119 | 2020-05-26 |
| 1659994739 | Jey Neuro Center, Inc | Psychiatry & Neurology | 2005 Eye Street #8-501, Bakersfield, CA 93301-4451 | 2020-05-22 |
| 1578116877 | La Neuro Medical Group | Psychiatry & Neurology | 11843 Dorothy St Apt 2, Los Angeles, CA 90049-4456 | 2019-07-17 |
| 1518527613 | Neuroguard Pro | Psychiatry & Neurology | 2932 N Cottonwood St Unit 16, Orange, CA 92865-1235 | 2019-06-19 |
| 1750857801 | Tms Depression Center of San Diego | Psychiatry & Neurology | 613 W Valley Pkwy Ste 102, Escondido, CA 92025-2550 | 2018-10-16 |
| 1225530637 | Iom Neuro Pro Reader | Psychiatry & Neurology | 9300 Santa Anita Ave, Suite 101, Rancho Cucamonga, CA 91730 | 2018-03-01 |
| 1437579851 | Sami Bajwa | Psychiatry & Neurology | 7240 N Van Ness Blvd, Fresno, CA 93711-0470 | 2014-04-24 |
| 1780935130 | Dawn Eliashiv Md Inc. A Professional Medical Corporation | Psychiatry & Neurology | 8635 W 3rd St Ste 1080w, Los Angeles, CA 90048-6183 | 2012-09-25 |
| 1073821922 | Yuvraj Singh Grewal | Psychiatry & Neurology | 23861 Mcbean Pkwy Ste A4, Santa Clarita, CA 91355-2003 | 2010-09-14 |
| 1952629263 | Roger Bertoldi Md Professional Corporation | Psychiatry & Neurology | 8610 S. Sepulveda Blvd., Los Angeles, CA 90045 | 2010-05-11 |
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| 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.