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. |
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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 |
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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 |
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Provider Enumeration Date | 02/26/2007 |
Last Update Date | 03/03/2020 |
Certification Date | 03/03/2020 |
Medicare PECOS PAC ID | 4981796141 |
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Medicare Enrollment ID | O20070817000600 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811023443 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084N0400X | Psychiatry & Neurology - Neurology | A85738 (California) | Primary |
Provider Name | Mohan V Tadikonda |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1326083858 PECOS PAC ID: 5799676649 Enrollment ID: I20070918000679 |
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