Provider Demographics
NPI:1710389887
Name:INTUITIVE NEUROLOGY INC
Entity Type:Organization
Organization Name:INTUITIVE NEUROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-996-1858
Mailing Address - Street 1:2490 HOSPITAL DR
Mailing Address - Street 2:STE.#212
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4122
Mailing Address - Country:US
Mailing Address - Phone:650-396-7769
Mailing Address - Fax:650-962-4533
Practice Address - Street 1:2490 HOSPITAL DR
Practice Address - Street 2:STE. #212
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4122
Practice Address - Country:US
Practice Address - Phone:650-396-7769
Practice Address - Fax:650-962-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-20
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA970892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CX837ZMedicare PIN