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General NPI Number Information
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NPI Number | 1366718165
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Entity Type | Organization
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Legal Business Name | NEUROCARE ELECTRODIAGNOSTICS A
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Dates
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Enumeration Date | 03/26/2012
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Last Update Date | 04/02/2012
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Provider Practice Location Address
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Address Line | 4987 GOLDEN FOOTHILL PKWY
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9364
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Country | US
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Telephone | 916-947-1980
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Fax | 916-941-0153
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Provider Business Mailing Address
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Address Line | PO BOX 1231
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City | FOLSOM
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State | CA
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Zip | 95763-1231
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Country | US
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Telephone | 916-947-1980
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Fax | 916-941-0153
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DARIN MICHAEL WHITE
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Credential | PT,DPT,ECS
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Telephone | 916-947-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number | PT26416
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License Number State | CA
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