Healthcare Provider Details

I. General information

NPI: 1619433372
Provider Name (Legal Business Name): OASIS NEUROLOGY AND PAIN INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10811 WASHINGTON BLVD STE 250
CULVER CITY CA
90232-3670
US

IV. Provider business mailing address

1424 WARNALL AVE
LOS ANGELES CA
90024-5333
US

V. Phone/Fax

Practice location:
  • Phone: 310-254-9015
  • Fax: 424-326-3253
Mailing address:
  • Phone: 954-638-8615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX SABO
Title or Position: CEO
Credential: MD
Phone: 954-638-8615