Healthcare Provider Details

I. General information

NPI: 1942993043
Provider Name (Legal Business Name): VASCULAR NEUROSCIENCES INSTITUTE OF FARWEST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2190 LYNN RD STE 380
THOUSAND OAKS CA
91360-8029
US

IV. Provider business mailing address

2190 LYNN RD STE 350
THOUSAND OAKS CA
91360-8028
US

V. Phone/Fax

Practice location:
  • Phone: 805-242-4884
  • Fax:
Mailing address:
  • Phone: 805-242-4884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD TAQI
Title or Position: CEO
Credential: MD
Phone: 760-423-3942