Healthcare Provider Details

I. General information

NPI: 1134088354
Provider Name (Legal Business Name): NEUROTRAUMA MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 E CHEVY CHASE DR STE 110
GLENDALE CA
91206-4091
US

IV. Provider business mailing address

960 W 7TH ST APT 4401
LOS ANGELES CA
90017-5982
US

V. Phone/Fax

Practice location:
  • Phone: 818-221-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ARASH YOUSEFI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 718-844-6244