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General NPI Number Information
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NPI Number | 1104831965
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Entity Type | Organization
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Legal Business Name | NEUROLOGY DOCTORS OF CALIFORNIA, INC.
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 2621 S BRISTOL ST # 105
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City | SANTA ANA
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State | CA
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Zip | 92704-5766
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Country | US
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Telephone | 714-540-1840
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Fax | 714-540-2319
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Provider Business Mailing Address
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Address Line | 2621 S BRISTOL ST # 105
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City | SANTA ANA
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State | CA
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Zip | 92704-5766
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Country | US
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Telephone | 714-540-1840
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Fax | 714-540-2319
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. M. MICHAEL MAHDAD
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Credential | M.D.
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Telephone | 714-546-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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