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General NPI Number Information
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NPI Number | 1801430400
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Entity Type | Organization
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Legal Business Name | NEURO CONSULTING INC
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 522 N SWEETZER AVE APT 5
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City | LOS ANGELES
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State | CA
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Zip | 90048-2659
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Country | US
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Telephone | 307-920-1688
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Fax | 818-510-0979
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Provider Business Mailing Address
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Address Line | 14637 1/2 TITUS ST UNIT C
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4942
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Country | US
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Telephone | 307-920-1688
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Fax | 818-510-0979
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM MICHAEL HAMMESFAHR
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Credential | MD
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Telephone | 307-920-1688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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