NEUROLOGIC, LLC (NPI# 1699100933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699100933 |
| Entity Type | Organization |
| Organization Name | NEUROLOGIC, LLC |
| Other Organization Name | NEUROLOGIC IOM |
| Practice Address |
29455 Vista Plaza Drive Laguna Niguel CA 92677 |
| Mailing Address |
8547 E. Arapahoe Rd. Ste. 555 Greenwood Village CO 80112 |
| Practice Telephone | 9492126679 |
| Practice Fax Number | 8668970799 |
| Mailing Telephone | 8774464945 |
| Mailing Fax Number | 8668970799 |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2015-04-29 |
| Authorized Official Name | MR. BRIAN WILLIAM TATOMIR (PRESIDENT) |
| Authorized Official Telephone | 9492126679 |
| Is Organization Subpart | Y |
| Parent Organization Name | NEUROLOGIC, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| Other Name | Type Code |
|---|---|
| NeuroLogic IOM | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386055234 | Neurologic, LLC | Psychiatry & Neurology | 420 The Pkwy, Suite A, Greer, SC 29650-5204 | 2014-05-14 |
| Street Address |
29455 VISTA PLAZA DRIVE |
| City | LAGUNA NIGUEL |
| State | CA |
| Zip Code | 92677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114566049 | Amber Kramer | Physical Therapist | 30100 Town Center Drive #yz, Laguna Niguel, CA 92677 | 2019-12-23 |
| 1811548340 | Morgan Peikar | Rehabilitation Hospital | 28441 Springfield Dr, Laguna Niguel, CA 92677 | 2019-09-25 |
| 1871056382 | Jacqueline Evamarie Serrano | Chiropractor | 28062 Forbes Road, Laguna Niguel, CA 92677 | 2019-04-11 |
| 1316408859 | Azadeh Ghafari | Social Worker | 30100 Town Center Dr # 179, Laguna Niguel, CA 92677 | 2019-03-27 |
| 1346741857 | Diana Wang | Physical Medicine & Rehabilitation | 30100 Town Center Drive Suite, Suite Yz, Laguna Niguel, CA 92677 | 2018-02-21 |
| 1750833554 | James H. Tran Dds, Dental Corp. | Dentist | 23876 Aliso Creek Road, Laguna Niguel, CA 92677 | 2016-10-27 |
| 1215486139 | Kevin Sun | Dentist | 49 Blue Horizon, Laguna Niguel, CA 92677 | 2016-10-04 |
| 1740637842 | Michael Dacosta | Dentist | 28862 Calle Vista, Laguna Niguel, CA 92677 | 2016-05-18 |
| 1235590373 | Adrian Gomez | Counselor | 24361 Nugget Falls Ln, Laguna Niguel, CA 92677 | 2016-03-17 |
| 1427455906 | Gracie Heart Home Health LLC | Home Health | 24318 El Pilar, Laguna Niguel, CA 92677 | 2014-11-26 |
| Find all providers in zip 92677 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619370814 | Intermountain Neurovision | Contractor | 30251 Golden Lantern, Suite E 577, Laguna Niguel, CA 92677-5993 | 2014-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194324012 | Bailey Rose Medical Billing LLC | Contractor | 839 Fan Palm Ln, Brentwood, CA 94513-5680 | 2020-10-21 |
| 1245837566 | Irshad H Fardan | Contractor | 2167 Pasetta Dr Apt 1, Santa Clara, CA 95050-3249 | 2020-10-09 |
| 1245838531 | Karen Strickland | Contractor | 3450 Sacramento St # 531, San Francisco, CA 94118-1914 | 2020-10-09 |
| 1831796879 | Laura Barker | Contractor | 55 River Oaks Pl Apt 381, San Jose, CA 95134-2074 | 2020-10-02 |
| 1477167054 | Jarib Takezhi Concilco Colin | Contractor | 3862 Sherwood Pl, Sherman Oaks, CA 91423-4608 | 2020-09-01 |
| 1609492289 | Neil Sankar | Contractor | 3610 Flora Vista Ave Apt 238, Santa Clara, CA 95051-3508 | 2020-06-19 |
| 1467077404 | Eric Avirett | Contractor | 1944 Bonita Ave, Berkeley, CA 94704-1038 | 2020-06-16 |
| 1699305805 | Sanjiv Ramdeo | Contractor | 710 Santa Susana St, Sunnyvale, CA 94085-3470 | 2020-01-16 |
| 1407498942 | Terry Lee Moffit | Contractor | 1165 W 15th St, San Bernardino, CA 92411-1811 | 2019-10-16 |
| 1538701693 | Ramin P Shirazi IIi | Contractor | 25411 Mina Ct, Lake Forest, CA 92630-5311 | 2019-10-10 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA NIGUEL |
| Zip Code | 92677 |
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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.