Healthcare Provider Details

I. General information

NPI: 1528595295
Provider Name (Legal Business Name): NEUROMED GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8780 VAN NUYS BLVD
PANORAMA CITY CA
91402
US

IV. Provider business mailing address

8306 WILSHIRE BLVD SUITE #943
BEVERLY HILLS CA
90211-2304
US

V. Phone/Fax

Practice location:
  • Phone: 818-984-8882
  • Fax: 818-894-3111
Mailing address:
  • Phone: 714-654-7990
  • Fax: 818-894-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA72796
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA112838
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: NADER ARMANIOUS
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D
Phone: 714-654-7990