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General NPI Number Information
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NPI Number | 1073144762
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Entity Type | Organization
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Legal Business Name | INTEGRATED NEUROLOGY & PAIN MANAGEMENT, PC
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Dates
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Enumeration Date | 01/31/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 155 GLEN COVE MARINA RD E STE 100
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City | VALLEJO
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State | CA
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Zip | 94591-7284
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Country | US
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Telephone | 707-980-6257
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Fax | 707-980-6692
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Provider Business Mailing Address
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Address Line | 712 BANCROFT ROAD STE 905
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City | WALNUT CREEK
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State | CA
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Zip | 94598-1531
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Country | US
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Telephone | 707-980-6257
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Fax | 707-980-6692
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Authorized Official
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Title or Position | CEO
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Name | DR. AMAR ANAND
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Credential | MD
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Telephone | 707-980-6257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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