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General NPI Number Information
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NPI Number | 1912792227
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Entity Type | Organization
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Legal Business Name | SV NEUROLOGY, LLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 3415 W GLENDALE AVE # 3B
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City | PHOENIX
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State | AZ
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Zip | 85051-8322
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Country | US
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Telephone | 602-889-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 2929 N 75TH AVE STE 15
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City | PHOENIX
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State | AZ
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Zip | 85033-5443
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Country | US
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Telephone | 602-354-4506
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JORGE GALLARDO
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Credential | DC
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Telephone | 480-630-9508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0301X
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Taxonomy Name | Brain Injury Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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