Neurophysiologic Laboratory

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

NEUROPHYSIOLOGIC LABORATORY

Practice address

24012 Calle de la Plata Ste 150
Laguna Hills, CA 92653-3632

Phone

(949) 837-1130

Fax

(949) 587-1068

NPI assigned

Jun 6, 2023

Organization subpart

No

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

Authorized official

Name

Michael W Shen, MD

Title

Partner

Phone

(949) 837-1130

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1114611712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24012 CALLE DE LA PLATA STE 150",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533632",
            "telephone_number": "949-837-1130",
            "fax_number": "949-587-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 CALLE DE LA PLATA STE 150",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533632",
            "telephone_number": "949-837-1130",
            "fax_number": "949-587-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPHYSIOLOGIC LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "SHEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "949-837-1130",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.