Provider Demographics
NPI:1740038082
Name:NEURO INTEGRITY PHYSICIANS OVERSIGHT
Entity type:Organization
Organization Name:NEURO INTEGRITY PHYSICIANS OVERSIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VITANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-923-1437
Mailing Address - Street 1:11049 MAGNOLIA BLVD APT 602
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-5664
Mailing Address - Country:US
Mailing Address - Phone:818-207-0267
Mailing Address - Fax:
Practice Address - Street 1:11049 MAGNOLIA BLVD APT 602
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-5664
Practice Address - Country:US
Practice Address - Phone:818-207-0267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty