Provider Demographics
NPI:1629141478
Name:NEUROLOGY CENTER OF NORTH ORANGE COUNTY, A MEDICAL CORP.
Entity Type:Organization
Organization Name:NEUROLOGY CENTER OF NORTH ORANGE COUNTY, A MEDICAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CIABARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:714-879-7200
Mailing Address - Street 1:381 E IMPERIAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835
Mailing Address - Country:US
Mailing Address - Phone:714-879-7200
Mailing Address - Fax:714-879-3010
Practice Address - Street 1:381 E IMPERIAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-879-7200
Practice Address - Fax:714-879-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0101950Medicaid
CAW16368Medicare ID - Type Unspecified