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General NPI Number Information
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NPI Number | 1801449392
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Entity Type | Organization
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Legal Business Name | NEUROLOGY AND COGNITIVE NEUROSCIENCE INSTITUTE, INC.
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 2080 CENTURY PARK E STE 1403
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City | LOS ANGELES
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State | CA
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Zip | 90067-2017
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Country | US
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Telephone | 949-239-4410
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Fax | 310-526-8770
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Provider Business Mailing Address
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Address Line | 2080 CENTURY PARK E STE 1403
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City | LOS ANGELES
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State | CA
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Zip | 90067-2017
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Country | US
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Telephone | 844-638-7637
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Fax | 310-526-8770
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARZIN BENJAMIN PEDOUIM
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Credential | MD
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Telephone | 310-562-5589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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