Healthcare Provider Details

I. General information

NPI: 1689781965
Provider Name (Legal Business Name): TOWER NEUROLOGICAL SERVICES, MEDICAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

7135 HOLLYWOOD BLVD SUITE 1206
LOS ANGELES CA
90046-3212
US

V. Phone/Fax

Practice location:
  • Phone: 310-659-1498
  • Fax: 310-659-1528
Mailing address:
  • Phone: 310-659-1498
  • Fax: 310-659-1528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberG82192
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG82192
License Number StateCA

VIII. Authorized Official

Name: DR. CAMERON RUSSELL ADAMS
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 310-659-1498