Provider Demographics
NPI:1811472202
Name:BRAINTHRIVE PC
Entity type:Organization
Organization Name:BRAINTHRIVE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING NEUROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:YUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPOPORT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-877-7000
Mailing Address - Street 1:32123 LINDERO CANYON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5461
Mailing Address - Country:US
Mailing Address - Phone:818-877-7000
Mailing Address - Fax:
Practice Address - Street 1:32123 LINDERO CANYON RD STE 210
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5461
Practice Address - Country:US
Practice Address - Phone:818-877-7000
Practice Address - Fax:818-877-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty