Provider Demographics
NPI:1124582424
Name:THE NEURON CLINIC GP
Entity Type:Organization
Organization Name:THE NEURON CLINIC GP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANKO
Authorized Official - Middle Name:N
Authorized Official - Last Name:HUISA-GARATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-462-4624
Mailing Address - Street 1:44045 MARGARITA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2729
Mailing Address - Country:US
Mailing Address - Phone:951-462-4624
Mailing Address - Fax:951-462-4625
Practice Address - Street 1:44045 MARGARITA RD STE 106
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2729
Practice Address - Country:US
Practice Address - Phone:951-462-4624
Practice Address - Fax:951-462-4625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty