KAIZEN BRAIN CENTER (NPI# 1891230868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891230868 |
| Entity Type | Organization |
| Organization Name | KAIZEN BRAIN CENTER |
| Other Organization Name | MEMORY CONCUSSION CENTER |
| Practice Address |
4510 Executive Dr Suite 107 San Diego CA 92121-3021 |
| Mailing Address |
9247 Piatto Ln San Diego CA 92108-4767 |
| Practice Telephone | 9492956693 |
| Practice Fax Number | 8587792511 |
| Mailing Telephone | 9492956693 |
| Mailing Fax Number | 8587792511 |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |
| Authorized Official Name | MOHAMMED MUZAMMIL AHMED (DIRECTOR) |
| Authorized Official Telephone | 8662772659 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084B0040X |
Psychiatry & Neurology Specialization: Behavioral Neurology & Neuropsychiatry |
A124696 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084P0301X |
Psychiatry & Neurology Specialization: Brain Injury Medicine |
A124696 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Memory Concussion Center | Former Legal Business Name - Organization |
| Street Address |
4510 EXECUTIVE DR SUITE 107 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-3021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538153747 | James Raymond Moitoza | Orthopaedic Surgery | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2005-09-01 |
| 1255999736 | Chelsea Vanderwoude | Student in an Organized Health Care Education/Training Program | 4510 Executive Dr, San Diego, CA 92121-3021 | 2019-05-30 |
| 1164959433 | Keri Anne O'connor | Registered Nurse | 4510 Executive Dr, San Diego, CA 92121-3021 | 2017-05-17 |
| 1285179614 | Hatem Abou-sayed Md Mba Facs - A Professional Medical Corporation | Plastic Surgery | 4510 Executive Dr, Suite 105, San Diego, CA 92121-3021 | 2016-12-20 |
| 1508310319 | Ana Ramirez | Psychologist | 4510 Executive Dr, Suite 315, San Diego, CA 92121-3021 | 2016-08-09 |
| 1457711657 | Achieve Tms Centers, LLC | Psychiatry & Neurology | 4510 Executive Dr, 115, San Diego, CA 92121-3021 | 2016-03-01 |
| 1932501640 | K Kohani D D S A Professional Corporation | Dentist | 4510 Executive Dr, Suite 205, San Diego, CA 92121-3021 | 2014-09-24 |
| 1306263470 | Eric Lamarca | Radiologic Technologist | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2014-03-26 |
| 1902220809 | Shashita Inamdar Md Professional Corporation | Psychiatry & Neurology | 4510 Executive Dr, Ste 115, San Diego, CA 92121-3021 | 2014-02-12 |
| 1457773699 | R.p. Dunnum, M.d. Inc. | Preventive Medicine | 4510 Executive Dr, Suite 107, San Diego, CA 92121-3021 | 2014-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 2084P0301X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Brain Injury Medicine |
| A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences. |
| Notes: Source: American Board of Physical Medicine and Rehabilitation, 2015. www.abpmr.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215593652 | California Institute of Neuroscience Inc | Psychiatry & Neurology | 2100 Lynn Rd Ste 120, Thousand Oaks, CA 91360-8033 | 2019-05-10 |
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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.