MEDICARE: MOBILE NEUROLOGY OF SAN DIEGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	A71659	CA

General Provider Information

NPI Number	:	1043621394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE NEUROLOGY OF SAN DIEGO

Provider Business Mailing Address
First Line	:	8851 CENTER DR
Second Line	:	SUITE 603
City	:	LA MESA
State	:	CA
Zip	:	91942-3017
Country	:	US
Telephone Number	:	619-667-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	8851 CENTER DR
Second Line	:	SUITE 603
City	:	LA MESA
State	:	CA
Zip	:	91942-3017
Country	:	US
Telephone Number	:	619-667-4545
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ER-KAI GAO
Credential	:	MD
Telephone Number	:	619-667-4545

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	03/10/2026

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