| California Neuroendovascular Specialists Medical Corporation | |
|
155 N Lake Ave Ste 800 Pasadena CA 91101-1857 | |
| (562) 491-9270 | |
| Not Available |
| Full Name | California Neuroendovascular Specialists Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 155 N Lake Ave Ste 800, Pasadena, California |
| Authorized Official Name and Position | Wled Wazni (PRESIDENT) |
| Authorized Official Contact | 5625225304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| California Neuroendovascular Specialists Medical Corporation 530 S Lake Ave # 439 Pasadena CA 91101-3515 Ph: (562) 522-5304 | California Neuroendovascular Specialists Medical Corporation 155 N Lake Ave Ste 800 Pasadena CA 91101-1857 Ph: (562) 491-9270 |
| NPI Number | 1689205049 |
|---|---|
| Provider Enumeration Date | 02/03/2020 |
| Last Update Date | 02/05/2020 |
| Certification Date | 02/05/2020 |
| Medicare PECOS PAC ID | 7315369022 |
|---|---|
| Medicare Enrollment ID | O20200625003335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689205049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A2900X | Psychiatry & Neurology - Neurocritical Care | (* (Not Available)) | Primary |
| Provider Name | Wled Wazni |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528297009 PECOS PAC ID: 8921224585 Enrollment ID: I20170525001050 |
| Provider Name | Aakash Nalinkant Bodhit |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487060166 PECOS PAC ID: 9234432220 Enrollment ID: I20211108001457 |
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