Provider Demographics
NPI:1154864874
Name:CENTER FOR NEUROHEALTH INC
Entity Type:Organization
Organization Name:CENTER FOR NEUROHEALTH INC
Other - Org Name:KAIZEN BRAIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:MUZAMMIL
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-893-0542
Mailing Address - Street 1:4180 LA JOLLA VILLAGE DR STE 240
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1471
Mailing Address - Country:US
Mailing Address - Phone:866-277-2659
Mailing Address - Fax:858-779-2511
Practice Address - Street 1:4180 LA JOLLA VILLAGE DR STE 240
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:866-277-2659
Practice Address - Fax:858-779-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1246962084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty