Healthcare Provider Details

I. General information

NPI: 1760827836
Provider Name (Legal Business Name): NEUROSCIENCE INSTITUTE OF NORTHERN CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 SAMARITAN DR SUITE 210
SAN JOSE CA
95124-4106
US

IV. Provider business mailing address

2520 SAMARITAN DR SUITE 210
SAN JOSE CA
95124-4106
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-8400
  • Fax: 408-356-0974
Mailing address:
  • Phone: 408-356-8400
  • Fax: 408-356-0974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: HARISH HK MURTHY
Title or Position: TREASURER
Credential: M.D.
Phone: 408-356-8400