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General NPI Number Information
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NPI Number | 1205368305
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Entity Type | Organization
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Legal Business Name | PINNACLE NEUROLOGY INC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 599 SIR FRANCIS DRAKE BLVD SUITE 206
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City | GREENBRAE
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State | CA
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Zip | 94904-1712
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Country | US
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Telephone | 415-578-3110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5357
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City | LARKSPUR
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State | CA
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Zip | 94977-5357
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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 | PRESIDENT
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Name | JOHN J PANAGOTACOS
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Credential | M.D.
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Telephone | 415-578-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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