Provider Demographics
NPI:1649095076
Name:ASTRA NEUROSURGICAL INSTITUTE, P.C.
Entity type:Organization
Organization Name:ASTRA NEUROSURGICAL INSTITUTE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABILASH
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARIDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-705-2439
Mailing Address - Street 1:PO BOX 8086
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91372-8086
Mailing Address - Country:US
Mailing Address - Phone:248-705-2439
Mailing Address - Fax:
Practice Address - Street 1:215 W JANSS RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1847
Practice Address - Country:US
Practice Address - Phone:248-705-2439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty