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General NPI Number Information
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NPI Number | 1972922714
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Entity Type | Organization
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Legal Business Name | CORTICARE, INC.
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 5901 PRIESTLY DR STE 306
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City | CARLSBAD
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State | CA
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Zip | 92008-8825
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Country | US
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Telephone | 888-482-2334
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Fax | 888-482-2334
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Provider Business Mailing Address
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Address Line | 5963 LA PLACE CT STE 309
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City | CARLSBAD
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State | CA
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Zip | 92008-8823
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Country | US
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Telephone | 888-482-2334
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID ROE
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Credential |
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Telephone | 760-270-9198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0500X
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Taxonomy Name | EEG Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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