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General NPI Number Information
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NPI Number | 1902553886
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Entity Type | Organization
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Legal Business Name | ON DEMAND NEUROLOGY OF CA PC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 4900 CALIFORNIA AVE STE 210B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7080
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Country | US
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Telephone | 650-387-6322
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Fax |
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Provider Business Mailing Address
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Address Line | 205 E 42ND ST STE 1947
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City | NEW YORK
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State | NY
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Zip | 10017-5773
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Country | US
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Telephone | 313-887-0960
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Fax | 212-214-0885
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Authorized Official
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Title or Position | HEAD OF PAYOR RELATIONS
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Name | JED REAUX
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Credential |
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Telephone | 337-772-9738
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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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