| Northridge Neurological Medical Group Inc | |
|
18251 Roscoe Blvd Suite 101 Northridge CA 91325-4200 | |
| (818) 349-2503 | |
| (818) 349-4724 |
| Full Name | Northridge Neurological Medical Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 18251 Roscoe Blvd, Northridge, California |
| Authorized Official Name and Position | Wei Mi (PRESIDENT) |
| Authorized Official Contact | 8183492503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northridge Neurological Medical Group Inc 17993 Mayerling St Granada Hills CA 91344-2126 Ph: (818) 349-2503 | Northridge Neurological Medical Group Inc 18251 Roscoe Blvd Suite 101 Northridge CA 91325-4200 Ph: (818) 349-2503 |
| NPI Number | 1184702557 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/26/2022 |
| Certification Date | 08/26/2022 |
| Medicare PECOS PAC ID | 8527095157 |
|---|---|
| Medicare Enrollment ID | O20050725001182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184702557 | NPI | - | NPPES |
| ZZZ78006Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (California) | Primary |
| Provider Name | Wei Mi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871601401 PECOS PAC ID: 7214953025 Enrollment ID: I20100201000295 |
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