| Pacific Neurology Consultants, Inc. | |
|
3191 Oak Knoll Dr Los Alamitos CA 90720-4516 | |
| (562) 365-3022 | |
| (888) 596-7302 |
| Full Name | Pacific Neurology Consultants, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3191 Oak Knoll Dr, Los Alamitos, California |
| Authorized Official Name and Position | Mohan Venkataratna Tadikonda (PRESIDENT) |
| Authorized Official Contact | 5623653022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Neurology Consultants, Inc. Po Box 6007 Long Beach CA 90806-0007 Ph: (562) 365-3022 | Pacific Neurology Consultants, Inc. 3191 Oak Knoll Dr Los Alamitos CA 90720-4516 Ph: (562) 365-3022 |
| NPI Number | 1811023443 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 03/03/2020 |
| Certification Date | 03/03/2020 |
| Medicare PECOS PAC ID | 4981796141 |
|---|---|
| Medicare Enrollment ID | O20070817000600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811023443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A85738 (California) | Primary |
| Provider Name | Mohan V Tadikonda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326083858 PECOS PAC ID: 5799676649 Enrollment ID: I20070918000679 |
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