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General NPI Number Information
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NPI Number | 1619779865
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Entity Type | Organization
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Legal Business Name | CALIFORNIA NEUROSCIENCE SPECIALISTS, APC
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 2200 COLLIER CT
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City | TUSTIN
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State | CA
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Zip | 92782-1525
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Country | US
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Telephone | 949-870-9784
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Fax |
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Provider Business Mailing Address
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Address Line | 12665 GARDEN GROVE BLVD STE 708
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1921
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Country | US
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Telephone | 714-973-1388
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Fax | 949-284-0604
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | DR. MIAN MOHSIN SHAH
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Credential | MD
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Telephone | 714-973-1388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery 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 | 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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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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