Provider Demographics
NPI:1619252020
Name:HOPE NEUROLOGIC CENTER
Entity Type:Organization
Organization Name:HOPE NEUROLOGIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BHAGWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORJANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-514-0166
Mailing Address - Street 1:PO BOX 6613
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92248-6613
Mailing Address - Country:US
Mailing Address - Phone:760-514-0166
Mailing Address - Fax:760-501-0719
Practice Address - Street 1:79440 CORPORATE CENTER DR
Practice Address - Street 2:SUITE 108
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-7241
Practice Address - Country:US
Practice Address - Phone:760-514-0166
Practice Address - Fax:760-501-0719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA620332084N0400X
2084N0402X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty