Pacific Neurology AMC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

G547910 Issued in CA

Legal business name

PACIFIC NEUROLOGY AMC

Practice address

3737 Moraga Ave Ste A5
San Diego, CA 92117-5459

Phone

(619) 443-0282

Fax

(619) 443-5337

NPI assigned

May 7, 2007

Last updated

Nov 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Robert Lasker, MDNPI 1043299399

Title

President

Phone

(619) 443-0282

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce R Lasker, MD

  • Neurology Physician
  • San Diego, CA
  • NPI 1043299399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1730392788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE STE A5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175459",
            "telephone_number": "619-443-0282",
            "fax_number": "619-443-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE STE A5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175459",
            "telephone_number": "619-443-0282",
            "fax_number": "619-443-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NEUROLOGY AMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "LASKER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-443-0282",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G547910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Integrative Therapy Inc
• Pacific Medical Network
• Pacific Medical/Bay Recovery
• Pacific Mindscape Medical Group
• Pacific Neurobehavioral Clinic: a Psychological Corporation
• Pacific Pathology, Inc.
• Pacific Pathology, Inc.
• Pacific Podiatry Consultants Inc
• Pacific Point HCS, Inc. (Pacific Point Home Health & Palliative Care)
• Pacific Point Health Care Services Inc (Pacific Point Home Health & Palliative Care)

• Neurology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.