Healthcare Provider Details

I. General information

NPI: 1184238933
Provider Name (Legal Business Name): EPILEPSY RHEUMATOLOGY AND ARTHRITIS SPECIALTY WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 N EL CAMINO REAL STE C208
ENCINITAS CA
92024-1332
US

IV. Provider business mailing address

13033 SIGNATURE PT APT 180
SAN DIEGO CA
92130
US

V. Phone/Fax

Practice location:
  • Phone: 314-825-7371
  • Fax: 866-777-8553
Mailing address:
  • Phone: 314-825-7371
  • Fax: 866-777-8553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HUMAYUN N BEG
Title or Position: PRESIDENT
Credential: MD
Phone: 314-825-7371