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General NPI Number Information
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NPI Number | 1104249291
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Entity Type | Organization
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Legal Business Name | NEUROGRAPHY INSTITUTE GLOBAL CONSULTING INC
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 2716 OCEAN PARK BLVD STE 3082
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City | SANTA MONICA
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State | CA
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Zip | 90405-5266
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Country | US
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Telephone | 310-314-6410
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Fax | 310-314-2414
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Provider Business Mailing Address
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Address Line | 2716 OCEAN PARK BLVD STE 3082
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City | SANTA MONICA
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State | CA
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Zip | 90405-5266
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Country | US
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Telephone | 310-314-6410
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Fax | 310-314-2414
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. AARON G FILLER
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Credential | M.D., PH.D., FRCS
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Telephone | 310-314-6410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | G81778
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License Number State | CA
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