Basic Information
| Provider Information | |||||||||
| NPI: | 1346625449 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED NEUROSURGICAL INSTITUTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 999 N TUSTIN AVE | ||||||||
| Address2: | SUITE 109 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927053528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148340439 | ||||||||
| FaxNumber: | 7148341076 | ||||||||
| Practice Location | |||||||||
| Address1: | 1441 CONSTITUTION BLVD | ||||||||
| Address2: | BLDG 300 | ||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939063100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317832506 | ||||||||
| FaxNumber: | 8317556297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2015 | ||||||||
| LastUpdateDate: | 07/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | TABRIZI | ||||||||
| AuthorizedOfficialFirstName: | PEYMAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | NEUROSURGEON | ||||||||
| AuthorizedOfficialTelephone: | 7148340439 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | A63188 | CA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.