Healthcare Provider Details

I. General information

NPI: 1114802246
Provider Name (Legal Business Name): CALIFORNIA NEUROLOGY CARE P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 S BROOKHURST ST STE 214
ANAHEIM CA
92804-3558
US

IV. Provider business mailing address

PO BOX 10016
SANTA ANA CA
92711-0016
US

V. Phone/Fax

Practice location:
  • Phone: 949-271-9192
  • Fax: 949-271-9195
Mailing address:
  • Phone: 949-271-9192
  • Fax: 949-271-9195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: HUSSAM SEIF EDDEINE
Title or Position: OWNER
Credential: MD
Phone: 480-262-3987