Provider Demographics
NPI:1932465432
Name:INSTITUTE OF NEUROSURGICAL INNOVATION INC A NON-PROFIT PUBLIC
Entity Type:Organization
Organization Name:INSTITUTE OF NEUROSURGICAL INNOVATION INC A NON-PROFIT PUBLIC
Other - Org Name:INSTITUTE OF NEURO INNOVATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:VOKSHOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-835-0341
Mailing Address - Street 1:3111 VIA DOLCE APT 604
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5078
Mailing Address - Country:US
Mailing Address - Phone:424-835-0341
Mailing Address - Fax:
Practice Address - Street 1:2001 SANTA MONICA BLVD # 760W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:424-835-0341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty