Provider Demographics
NPI:1659849040
Name:NEUROLOGICAL INSTITUTE OF LOS ANGELES
Entity type:Organization
Organization Name:NEUROLOGICAL INSTITUTE OF LOS ANGELES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER (CEO)
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-824-3674
Mailing Address - Street 1:PO BOX 41748
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93384-1748
Mailing Address - Country:US
Mailing Address - Phone:323-638-1474
Mailing Address - Fax:888-642-9441
Practice Address - Street 1:8530 WILSHIRE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3113
Practice Address - Country:US
Practice Address - Phone:310-933-4590
Practice Address - Fax:310-526-3452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty