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General NPI Number Information
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NPI Number | 1679214902
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Entity Type | Organization
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Legal Business Name | NEUROVIBE LLC
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 3151 AIRWAY AVE STE N2
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City | COSTA MESA
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State | CA
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Zip | 92626-4626
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Country | US
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Telephone | 949-689-6607
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Fax |
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Provider Business Mailing Address
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Address Line | 3151 AIRWAY AVE STE N2
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City | COSTA MESA
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State | CA
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Zip | 92626-4626
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Country | US
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Telephone | 949-689-6607
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Fax |
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Authorized Official
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Title or Position | MBR
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Name | MR. JOSEPH KYONG CHOI
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Credential |
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Telephone | 949-378-7982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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