Healthcare Provider Details

I. General information

NPI: 1205544467
Provider Name (Legal Business Name): GAMMA MANAGEMENT PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20331 IRVINE AVE STE E2
NEWPORT BEACH CA
92660-0223
US

IV. Provider business mailing address

20331 IRVINE AVE STE E2
NEWPORT BEACH CA
92660-0223
US

V. Phone/Fax

Practice location:
  • Phone: 949-212-6679
  • Fax:
Mailing address:
  • Phone: 949-212-6679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084D0003X
TaxonomyDiagnostic Neuroimaging (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN TATOMIR
Title or Position: MANAGING PARTNER
Credential:
Phone: 949-212-6679