Healthcare Provider Details

I. General information

NPI: 1467135145
Provider Name (Legal Business Name): AMS NEURO GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9846 WHITE OAK AVE STE 202
NORTHRIDGE CA
91325-4806
US

IV. Provider business mailing address

9846 WHITE OAK AVE STE 202
NORTHRIDGE CA
91325-4806
US

V. Phone/Fax

Practice location:
  • Phone: 747-232-4283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MIKAYEL HAKOBYAN
Title or Position: CEO
Credential:
Phone: 747-232-4283