Provider Demographics
NPI:1073144762
Name:INTEGRATED NEUROLOGY & PAIN MANAGEMENT, PC
Entity Type:Organization
Organization Name:INTEGRATED NEUROLOGY & PAIN MANAGEMENT, PC
Other - Org Name:VIRTUAL CONSULT MD, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-980-6257
Mailing Address - Street 1:712 BANCROFT ROAD STE 905
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-1531
Mailing Address - Country:US
Mailing Address - Phone:707-980-6257
Mailing Address - Fax:707-980-6692
Practice Address - Street 1:155 GLEN COVE MARINA RD E STE 100
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-7284
Practice Address - Country:US
Practice Address - Phone:707-980-6257
Practice Address - Fax:707-980-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty