| Epilepsy And Brain Mapping Program, A Medical Group, Inc. | |
|
10 Congress St Suite 505 Pasadena CA 91105-3045 | |
| (626) 792-7300 | |
| (626) 792-7336 |
| Full Name | Epilepsy And Brain Mapping Program, A Medical Group, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 10 Congress St, Pasadena, California |
| Authorized Official Name and Position | William W. Sutherling (PRESIDENT) |
| Authorized Official Contact | 6267927300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Epilepsy And Brain Mapping Program, A Medical Group, Inc. 10 Congress St Suite 505 Pasadena CA 91105-3045 Ph: (626) 792-7300 | Epilepsy And Brain Mapping Program, A Medical Group, Inc. 10 Congress St Suite 505 Pasadena CA 91105-3045 Ph: (626) 792-7300 |
| NPI Number | 1679507172 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 06/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679507172 | NPI | - | NPPES |
| GR0100610 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | G45896 (California) | Primary |
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