Provider Demographics
NPI:1780745067
Name:WESTERN NEUROSURGICAL MEDICAL GROUP
Entity type:Organization
Organization Name:WESTERN NEUROSURGICAL MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-792-2911
Mailing Address - Street 1:3868 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1430
Mailing Address - Country:US
Mailing Address - Phone:510-792-2911
Mailing Address - Fax:510-794-7924
Practice Address - Street 1:3868 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1430
Practice Address - Country:US
Practice Address - Phone:510-792-2911
Practice Address - Fax:510-794-7924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty