MEDICARE: SADDLEBACK NEUROLOGY

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	:	1972451888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SADDLEBACK NEUROLOGY

Provider Business Mailing Address
First Line	:	23961 CALLE DE LA MAGDALENA STE 402
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3685
Country	:	US
Telephone Number	:	949-837-1450
Fax Number	:	949-587-5787

Provider Business Practice Location Address
First Line	:	23961 CALLE DE LA MAGDALENA STE 402
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3685
Country	:	US
Telephone Number	:	949-837-1450
Fax Number	:	949-587-5787

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	KIET M LOC
Credential	:	MD
Telephone Number	:	949-837-1450

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “SADDLEBACK NEUROLOGY ” Practice Location

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