| Neurospa Brain Rejuvenation Center, Inc. | |
|
2121 E Coast Hwy Ste 260 Corona Del Mar CA 92625-1932 | |
| (949) 652-7301 | |
| (949) 652-7301 |
| Full Name | Neurospa Brain Rejuvenation Center, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2121 E Coast Hwy Ste 260, Corona Del Mar, California |
| Authorized Official Name and Position | Ali Elahi (CEO/PRESIDENT) |
| Authorized Official Contact | 9497059964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurospa Brain Rejuvenation Center, Inc. 2121 E Coast Hwy Ste 260 Corona Del Mar CA 92625-1932 Ph: (949) 652-7301 | Neurospa Brain Rejuvenation Center, Inc. 2121 E Coast Hwy Ste 260 Corona Del Mar CA 92625-1932 Ph: (949) 652-7301 |
| NPI Number | 1093280976 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 02/08/2021 |
| Certification Date | 02/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093280976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
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