Provider Demographics
NPI:1326609124
Name:VASCULAR NEUROLOGY OF SOUTHERN CALIFORNIA INC
Entity Type:Organization
Organization Name:VASCULAR NEUROLOGY OF SOUTHERN CALIFORNIA INC
Other - Org Name:VNSC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ASIF
Authorized Official - Last Name:TAQI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-242-4884
Mailing Address - Street 1:17525 VENTURA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-5109
Mailing Address - Country:US
Mailing Address - Phone:818-986-2861
Mailing Address - Fax:818-638-5762
Practice Address - Street 1:227 W JANSS RD STE 125
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1856
Practice Address - Country:US
Practice Address - Phone:805-242-4884
Practice Address - Fax:805-242-4885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty