SOUTH BAY NEUROLOGICAL DIAGNOSTIC CENTER, INC (NPI# 1265661540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265661540 |
| Entity Type | Organization |
| Organization Name | SOUTH BAY NEUROLOGICAL DIAGNOSTIC CENTER, INC |
| Practice Address |
13252 Hawthorne Blvd Suite 100 Hawthorne CA 90250-5816 |
| Practice Telephone | 3106751555 |
| Practice Fax Number | 3106753355 |
| Mailing Telephone | 3106751555 |
| Mailing Fax Number | 3106753355 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-07-08 |
| Authorized Official Name | MR. DENISE MURIEL MCCARTHY (ADMINISTRATOR) |
| Authorized Official Telephone | 3106751555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
CA | Ambulatory Health Care Facilities |
| Street Address |
13252 HAWTHORNE BLVD SUITE 100 |
| City | HAWTHORNE |
| State | CA |
| Zip Code | 90250-5816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558589176 | Nina Le | Dentist | 13252 Hawthorne Blvd, Ste. 204, Hawthorne, CA 90250-5804 | 2007-04-20 |
| 1619105947 | West Coast Outpatient Services, Inc | Counselor | 13252 Hawthorne Blvd, 103, Hawthorne, CA 90250-5816 | 2009-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508479627 | Alexis Lemmon | Dental Hygienist | 13450 Hawthrone Blvd, Hawthorne, CA 90250 | 2020-08-28 |
| 1336620459 | Lan Ngoc Ton | Dentist | 13450 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2018-08-27 |
| 1356829261 | Karneth Health Inc | Internal Medicine | 4512 W. Imperial Hwy, Ste B, Hawthorne, CA 90250 | 2018-08-02 |
| 1225524663 | Viridian Healthcare LLC | In Home Supportive Care | 13658 Hawthorne Blvd Ste 201, Hawthorne, CA 90250 | 2018-07-09 |
| 1235636044 | Sonia Medical Center Inc | Clinic/Center | 4512 W Imperial Hwy, Hawthorne, CA 90250 | 2018-04-09 |
| 1518484807 | Jessica Anne-marie Auzenne-harris | Nurse Practitioner | 12618 Hawthorne Blvd, Hawthorne, CA 90250 | 2017-08-28 |
| 1669993358 | Ololade Olamide Obafemi | Nurse Practitioner | 12954 Hawthorne Boulevard, Suite 104, Hawthorne Morningside Medical Clinic, Hawthorne, CA 90250 | 2017-07-03 |
| 1588194534 | Marissam Medical Inc. | Durable Medical Equipment & Medical Supplies | 13508 Inglewood Ave, Hawthorne, CA 90250 | 2017-06-13 |
| 1043751886 | Ogbonna Iwuamadi Olelewe | Nurse Practitioner | 11712 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2017-03-13 |
| 1952758898 | La Shada Kai Martin | Contractor | 13010 Kornblum Ave, Unit D, Hawthorne, CA 90250 | 2016-05-20 |
| Find all providers in zip 90250 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992965859 | Kenneth H Geiger | Clinic/Center | 12321 Hawthorne Blvd, Hawthorne, CA 90250-3840 | 2008-06-13 |
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| 1497363212 | Joana Anjeh Tala | Clinic/Center | 2951 Hampshire Cir, Corona, CA 92879-6133 | 2020-07-17 |
| 1376160580 | Beyond Practice, Inc. | Clinic/Center | 300 W Ocean Blvd Apt 6114, Long Beach, CA 90802-8029 | 2020-07-03 |
| 1205452315 | Affection Healthcare LLC | Clinic/Center | 1641 North Ripon Road, Ripon, CA 95366 | 2020-06-24 |
| 1467074963 | Onclick Healthcare Incorporated | Clinic/Center | 2625 Townsgate Rd Ste 330, Westlake Village, CA 91361-5749 | 2020-05-07 |
| 1811517832 | D.e. Garrison, D.o., Inc. | Clinic/Center | 3209 Esplanade Ste 120, Chico, CA 95973-0154 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
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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.