Neurology & Pain Specialty Center | |
5 Journey Ste 210 Aliso Viejo CA 92656-5332 | |
(949) 305-7122 | |
(949) 305-7160 |
Full Name | Neurology & Pain Specialty Center |
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Speciality | Psychiatry & Neurology |
Location | 5 Journey Ste 210, Aliso Viejo, California |
Authorized Official Name and Position | Kenneth Patrick Martinez (NEUROLOGIST) |
Authorized Official Contact | 9493057122 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neurology & Pain Specialty Center 5 Journey Suite 210 Aliso Viejo CA 92656-5336 Ph: (949) 305-7122 | Neurology & Pain Specialty Center 5 Journey Ste 210 Aliso Viejo CA 92656-5332 Ph: (949) 305-7122 |
NPI Number | 1255537957 |
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Provider Enumeration Date | 06/21/2007 |
Last Update Date | 07/21/2022 |
Certification Date | 01/07/2020 |
Medicare PECOS PAC ID | 9133115629 |
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Medicare Enrollment ID | O20040421000850 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255537957 | NPI | - | NPPES |
A66709 | Other | CA | CA LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (California) | Primary |
Provider Name | Kenneth P Martinez |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1093825259 PECOS PAC ID: 1153317656 Enrollment ID: I20040422001240 |
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