Provider Demographics
NPI:1396462271
Name:TMS TRAUMA TREATMENT CENTER
Entity type:Organization
Organization Name:TMS TRAUMA TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIVIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-918-3954
Mailing Address - Street 1:881 ALMA REAL DR,
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272
Mailing Address - Country:US
Mailing Address - Phone:310-713-9855
Mailing Address - Fax:
Practice Address - Street 1:881 ALMA REAL DR,
Practice Address - Street 2:SUITE 310
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272
Practice Address - Country:US
Practice Address - Phone:310-713-9855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty