Provider Demographics
NPI:1770808883
Name:NEURO SPINE AND HEADACHE PAIN MANAGEMENT CENTER
Entity type:Organization
Organization Name:NEURO SPINE AND HEADACHE PAIN MANAGEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAYED
Authorized Official - Middle Name:
Authorized Official - Last Name:MONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-300-0885
Mailing Address - Street 1:PO BOX 27518
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0117
Mailing Address - Country:US
Mailing Address - Phone:760-351-8669
Mailing Address - Fax:760-351-8894
Practice Address - Street 1:195 W LEGION RD
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7714
Practice Address - Country:US
Practice Address - Phone:760-351-8669
Practice Address - Fax:760-351-8894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA101939Medicare PIN