| Synapse Neurology Inc A Professional Corporation | |
|
323 N Prairie Ave Suite 200 Inglewood CA 90301-4502 | |
| (310) 680-0560 | |
| (310) 680-0565 |
| Full Name | Synapse Neurology Inc A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 323 N Prairie Ave, Inglewood, California |
| Authorized Official Name and Position | David Kheradyar (PRESIDENT) |
| Authorized Official Contact | 3106800560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Synapse Neurology Inc A Professional Corporation 323 N Prairie Ave Suite 200 Inglewood CA 90301-4502 Ph: (310) 680-0560 | Synapse Neurology Inc A Professional Corporation 323 N Prairie Ave Suite 200 Inglewood CA 90301-4502 Ph: (310) 680-0560 |
| NPI Number | 1306094925 |
|---|---|
| Provider Enumeration Date | 09/08/2008 |
| Last Update Date | 03/05/2009 |
| Medicare PECOS PAC ID | 0244396802 |
|---|---|
| Medicare Enrollment ID | O20090305000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306094925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A74610 (California) | Primary |
| Provider Name | David Kheradyar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518917640 PECOS PAC ID: 7618956236 Enrollment ID: I20040716001099 |
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