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General NPI Number Information
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NPI Number | 1134631666
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL NEURORADIOLOGY, INC
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 23052 ALICIA PKWY
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City | MISSION VIEJO
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State | CA
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Zip | 92692-1643
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Country | US
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Telephone | 714-808-9797
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Fax |
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Provider Business Mailing Address
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Address Line | 23052 ALICIA PARKWAY 619
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City | MISSION VIEJO
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State | CA
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Zip | 92692
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | RAMIN SEAN PAKBAZ
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Credential | MD
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Telephone | 714-808-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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