MEDICARE: AMBULATORY NEUROLOGICAL SERVICES, LLC

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

General Provider Information

NPI Number	:	1184051583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBULATORY NEUROLOGICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 28669
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92198-0669
Country	:	US
Telephone Number	:	888-447-5904
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212 BATH AVE
Second Line	:	STE 535
City	:	ASHLAND
State	:	KY
Zip	:	41101-2680
Country	:	US
Telephone Number	:	888-447-5904
Fax Number	:	866-273-5772

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MIGUEL IRIBARREN
Credential	:
Telephone Number	:	847-340-9726

Provider Enumeration Date	:	09/30/2013
Last Update Date	:	03/13/2026

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