| Neuranimus P C | |
|
111 N Market St Ste 300 San Jose CA 95113-1116 | |
| (805) 608-3600 | |
| Not Available |
| Full Name | Neuranimus P C |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 111 N Market St Ste 300, San Jose, California |
| Authorized Official Name and Position | Michael Wasser (MANAGER) |
| Authorized Official Contact | 8056083600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuranimus P C 1511 3rd Ave Ste 1000 Seattle WA 98101-3637 Ph: () - | Neuranimus P C 111 N Market St Ste 300 San Jose CA 95113-1116 Ph: (805) 608-3600 |
| NPI Number | 1235863184 |
|---|---|
| Provider Enumeration Date | 07/14/2022 |
| Last Update Date | 11/21/2022 |
| Certification Date | 11/21/2022 |
| Medicare PECOS PAC ID | 8527437318 |
|---|---|
| Medicare Enrollment ID | O20221219001065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235863184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | (* (Not Available)) | Secondary |
| Provider Name | Ambooj Tiwari |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609198779 PECOS PAC ID: 3577783620 Enrollment ID: I20180827001056 |
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