Healthcare Provider Details

I. General information

NPI: 1467897322
Provider Name (Legal Business Name): WEST COAST NEUROLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 FAIR OAKS AVE STE 175
SOUTH PASADENA CA
91030-2683
US

IV. Provider business mailing address

625 FAIR OAKS AVE STE 175
SOUTH PASADENA CA
91030-2683
US

V. Phone/Fax

Practice location:
  • Phone: 626-598-3770
  • Fax: 626-598-3797
Mailing address:
  • Phone: 626-598-3770
  • Fax: 626-598-3797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA101958
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberA101958
License Number StateCA

VIII. Authorized Official

Name: DR. EDWARD BARTON
Title or Position: CEO
Credential: MD
Phone: 626-598-3770