Provider Demographics
NPI:1013584002
Name:WESTSIDE NEUROTHERAPEUTICS INC
Entity Type:Organization
Organization Name:WESTSIDE NEUROTHERAPEUTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-892-1157
Mailing Address - Street 1:10780 SANTA MONICA BLVD STE 470
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7616
Mailing Address - Country:US
Mailing Address - Phone:310-208-7144
Mailing Address - Fax:310-209-0444
Practice Address - Street 1:10850 WILSHIRE BLVD STE 1260
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4337
Practice Address - Country:US
Practice Address - Phone:310-208-7144
Practice Address - Fax:310-209-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty