Pacific Neuroscience Institute Medical Group Inc

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

FNP545334 Issued in CA

Legal business name

PACIFIC NEUROSCIENCE INSTITUTE MEDICAL GROUP INC

Practice address

11645 Wilshire Boulevard
6TH Floor
Los Angeles, CA 90025-6807

Phone

(310) 477-5558

Fax

(310) 477-7281

NPI assigned

Jun 23, 2016

Last updated

Jun 23, 2016By 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

Dr. Daniel F Kelly, MDNPI 1306857982

Title

Chairman

Phone

(310) 477-5558

Specialties & licenses 1

Addresses

Locations

Practitioners 5

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.

• Daniel F Kelly, MD

  • Neurological Surgery Physician
  • Santa Monica, CA
  • NPI 1306857982
  NPD Authorized official
• Carmen Olivia Doyle, PA-C

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1659590883
  NPD (past)
• Amalia Arasula Eisenberg, A.R.N.P.

  • Acute Care Nurse Practitioner
  • Santa Monica, CA
  • NPI 1255739835
  NPD (past)
• Chester F Griffiths, MD, FACS

  • Otolaryngology Physician
  • Los Angeles, CA
  • NPI 1104939248
  NPD (past)
• Melita Talene Petrossian, MD

  • Neurology Physician
  • Santa Monica, CA
  • NPI 1790812162
  NPD (past)

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1750732533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BOULEVARD",
            "address_2": "6TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256807",
            "telephone_number": "310-477-5558",
            "fax_number": "310-477-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BOULEVARD",
            "address_2": "6TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256807",
            "telephone_number": "310-477-5558",
            "fax_number": "310-477-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NEUROSCIENCE INSTITUTE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "310-477-5558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "FNP545334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Hearing , Inc
• Pacific Hearing & Balance., Inc
• Pacific Hospice Care Corporation
• Pacific Hospitalists, Inc.
• Pacific MRI a Nursing Corporation
• Pacific Ocean Dental Group,Hyun Sook Lim Dental Corporation (Pacific Ocean Dental Group)
• Pacific Ocean Medical Clinic
• Pacific Orthopaedic Institute
• Pacific Orthopedic and Rehabilitation Medical Center, Inc.
• Pacific Pain Control Clinic

• Neurological Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.