Healthcare Provider Details

I. General information

NPI: 1356204002
Provider Name (Legal Business Name): NEUROMIND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 W OLYMPIC BLVD STE 775
LOS ANGELES CA
90064-1850
US

IV. Provider business mailing address

3600 HARBOR BLVD STE 110-369
OXNARD CA
93035-4136
US

V. Phone/Fax

Practice location:
  • Phone: 424-369-9000
  • Fax: 424-369-0990
Mailing address:
  • Phone: 424-369-9000
  • Fax: 424-369-0990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BJ ADREZIN
Title or Position: CEO
Credential:
Phone: 424-369-9000