Provider Demographics
NPI:1427604065
Name:HKLA NEUROPAIN
Entity Type:Organization
Organization Name:HKLA NEUROPAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIRSH
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVEESHVAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-933-0323
Mailing Address - Street 1:2204 S BENTLEY AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-5501
Mailing Address - Country:US
Mailing Address - Phone:248-933-0323
Mailing Address - Fax:661-288-7903
Practice Address - Street 1:2204 S BENTLEY AVE APT 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5501
Practice Address - Country:US
Practice Address - Phone:248-933-0323
Practice Address - Fax:661-288-7903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty