Organization Active NPI

Neurology Doctors of California, Inc.

  • Specialist
  • Santa Ana, CA
National Provider Identifier
1104831965
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEUROLOGY DOCTORS OF CALIFORNIA, INC.
Practice address
2621 S Bristol St
# 105
Santa Ana, CA 92704-5766
Phone
(714) 540-1840
Fax
(714) 540-2319
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Dr. M. Michael Mahdad, M.D.
Title
President
Phone
(714) 546-5505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2621 S Bristol St
# 105
Santa Ana, CA 92704-5766

Mailing address

2621 S Bristol St
# 105
Santa Ana, CA 92704-5766
Phone (714) 540-1840

Other identifiers 3

IdentifierTypeStateIssuer
GR0086520OtherCAMEDI-CAL
CK6215OtherCARAILROAD MEDICARE NUMBER
ZZZ04904ZOtherCABLUE SHIELD OF CA.

Other names 1

  • southern california neurology specialists med.grp. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050509001077 CA Part B Supplier - Clinic/Group Practice 0941240907 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA; Irvine, CA

National Provider Directory

National Provider Directory

Locations

16300 Sand Canyon Ave
Ste 609
Irvine, CA 92618
Phone (714) 848-8585

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1104831965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 S BRISTOL ST",
            "address_2": "# 105",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045766",
            "telephone_number": "714-540-1840",
            "fax_number": "714-540-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 S BRISTOL ST",
            "address_2": "# 105",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045766",
            "telephone_number": "714-540-1840",
            "fax_number": "714-540-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY DOCTORS OF CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "MAHDAD",
        "authorized_official_first_name": "M. MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-546-5505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0086520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "CK6215",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA.",
            "identifier": "ZZZ04904Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "southern california neurology specialists med.grp.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.