Provider Demographics
NPI:1922579515
Name:AMOUSSOU NEUROLOGY ASSOCIATES, INC
Entity Type:Organization
Organization Name:AMOUSSOU NEUROLOGY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOUSSOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-638-1474
Mailing Address - Street 1:215 CONSTANCE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3519
Mailing Address - Country:US
Mailing Address - Phone:323-638-1474
Mailing Address - Fax:800-437-3507
Practice Address - Street 1:215 CONSTANCE LN
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3519
Practice Address - Country:US
Practice Address - Phone:323-638-1474
Practice Address - Fax:800-437-3507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-08
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty