Adult Neurology Specialists Inc | |
729 Sunrise Ave Ste 616 Roseville CA 95661-4548 | |
(954) 732-1211 | |
Not Available |
Full Name | Adult Neurology Specialists Inc |
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Speciality | Psychiatry & Neurology |
Location | 729 Sunrise Ave Ste 616, Roseville, California |
Authorized Official Name and Position | Kauroon Mazdak Darya (CEO) |
Authorized Official Contact | 4086799807 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Adult Neurology Specialists Inc 729 Sunrise Ave Ste 616 Roseville CA 95661-4548 Ph: (954) 732-1211 | Adult Neurology Specialists Inc 729 Sunrise Ave Ste 616 Roseville CA 95661-4548 Ph: (954) 732-1211 |
NPI Number | 1336749100 |
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Provider Enumeration Date | 10/29/2020 |
Last Update Date | 10/29/2020 |
Certification Date | 10/29/2020 |
Medicare PECOS PAC ID | 1759794092 |
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Medicare Enrollment ID | O20210317001980 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336749100 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Kauroon Mazdak Darya |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1922414796 PECOS PAC ID: 7012251713 Enrollment ID: I20210106000782 |
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