Neurospa Brain Rejuvenation Center, Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

NEUROSPA BRAIN REJUVENATION CENTER, INC.

Practice address

2121 E Coast Hwy Ste 260
Corona del Mar, CA 92625-1932

Phone

(949) 652-7301

Fax

(949) 652-7301

NPI assigned

Oct 8, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ali Elahi, MDNPI 1619983533

Title

Ceo/President

Phone

(949) 705-9964

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ali Elahi, MD

  • Neurology Physician
  • Corona del Mar, CA
  • NPI 1619983533
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1093280976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY STE 260",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251932",
            "telephone_number": "949-652-7301",
            "fax_number": "949-652-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY STE 260",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251932",
            "telephone_number": "949-652-7301",
            "fax_number": "949-652-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSPA BRAIN REJUVENATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "ELAHI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "949-705-9964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahrzad Mokhtare, MD
• Anita Caroline Moniuszko, DPM
• Ross Morales, PA-C
• Rebecca Katherine Mote
• Moving Forward Treatment LLC
• Newsport Physical Therapy
• Nextplay Nutrition LLC
• Christopher Cao Nguyen
• Quyen V. Nguyen, FNP-C
• Yvonne D Nguyen, PHARM D

• Neurology Physician in Corona del Mar, CA
• Providers in Corona del Mar, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.