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General NPI Number Information
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NPI Number | 1205544467
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Entity Type | Organization
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Legal Business Name | GAMMA MANAGEMENT PARTNERS LLC
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 20331 IRVINE AVE STE E2
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-0223
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Country | US
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Telephone | 949-212-6679
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Fax |
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Provider Business Mailing Address
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Address Line | 20331 IRVINE AVE STE E2
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-0223
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Country | US
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Telephone | 949-212-6679
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | BRIAN TATOMIR
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Credential |
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Telephone | 949-212-6679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (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 | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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