Healthcare Provider Details

I. General information

NPI: 1629986179
Provider Name (Legal Business Name): NERUOVISTA MD GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6260 LAUREL CANYON BLVD STE 205
NORTH HOLLYWOOD CA
91606-3250
US

IV. Provider business mailing address

6260 LAUREL CANYON BLVD STE 205
NORTH HOLLYWOOD CA
91606-3250
US

V. Phone/Fax

Practice location:
  • Phone: 424-239-4017
  • Fax:
Mailing address:
  • Phone: 424-239-4017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID EDELMAN
Title or Position: CEO
Credential: MD
Phone: 424-239-4017