Adult Neurology Specialists Inc
Organization Active NPI Neurology Physician · Roseville, CA
NPI 1336749100 · NPPES record last updated Oct 29, 2020
Key facts
- NPI
- 1336749100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- Legal business name
- ADULT NEUROLOGY SPECIALISTS INC
- Practice address
- 729 Sunrise Ave Ste 616
Roseville, CA 95661-4548 - Phone
- (954) 732-1211
- NPI assigned
- Oct 29, 2020
- Organization subpart
- No
Authorized official
- Name
- Kauroon Mazdak Darya, DO
- Title
- Ceo
- Phone
- (408) 679-9807
Practitioners 1
-
Kauroon Mazdak Darya, D.O
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210317001980 | CA | Part B Supplier - Clinic/Group Practice | 1759794092 |
Receives reassigned benefits from 1 practitioner Practice locations: Roseville, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | Yes |
Addresses
Primary practice location
729 Sunrise Ave Ste 616
Roseville, CA 95661-4548
Mailing address
729 Sunrise Ave Ste 616
Roseville, CA 95661-4548
Phone (954) 732-1211
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- Mireille Dora Adelson
- Meira Adler
- Jeffrey Adorador
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All providers in Roseville, CA · Neurology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.