Provider Demographics
NPI:1649862715
Name:CNS MEDICAL PC
Entity type:Organization
Organization Name:CNS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SEMYON
Authorized Official - Middle Name:
Authorized Official - Last Name:FAYNBOYM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-638-4263
Mailing Address - Street 1:19401 S VERMONT AVE STE K100K
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1029
Mailing Address - Country:US
Mailing Address - Phone:323-638-4263
Mailing Address - Fax:
Practice Address - Street 1:19401 S VERMONT AVE STE K100K
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1029
Practice Address - Country:US
Practice Address - Phone:323-638-4263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty