| Md Neurodiagnostic Mgt Svcs | |
|
2655 1st St Ste 250 Simi Valley CA 93065-1574 | |
| (818) 600-1572 | |
| (877) 705-3046 |
| Full Name | Md Neurodiagnostic Mgt Svcs |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2655 1st St Ste 250, Simi Valley, California |
| Authorized Official Name and Position | Julio Cantero (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8186001572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Neurodiagnostic Mgt Svcs Po Box 941715 Simi Valley CA 93094-1715 Ph: (818) 600-1572 | Md Neurodiagnostic Mgt Svcs 2655 1st St Ste 250 Simi Valley CA 93065-1574 Ph: (818) 600-1572 |
| NPI Number | 1114478849 |
|---|---|
| Provider Enumeration Date | 10/18/2016 |
| Last Update Date | 10/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114478849 | NPI | - | NPPES |
| 30990Z | Other | FL | 30990Z |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | CA129953 (California) | Primary |
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | ME94218 (Florida) | Secondary |
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