Neurocenter for Pain and Tremor a Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A38243 Issued in CA

Legal business name

NEUROCENTER FOR PAIN AND TREMOR A MEDICAL GROUP INC

Doing business as

jacob chodakiewitz md

Practice address

1125 S Beverly Dr Ste 610
Los Angeles, CA 90035-1182

Phone

(310) 553-3379

Fax

(310) 847-9714

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Jacob W Chodakiewitz, MD

Title

President

Phone

(310) 553-3379

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• jacob chodakiewitz md Doing business as

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.

• Jacobo W Chodakiewitz, M.D.

  • Specialist
  • Los Angeles, CA
  • NPI 1720263924
  Medicare reassignment NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1760566400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR",
            "address_2": "STE.610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351148",
            "telephone_number": "310-553-3379",
            "fax_number": "310-847-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351182",
            "telephone_number": "310-553-3379",
            "fax_number": "310-847-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROCENTER FOR PAIN AND TREMOR A MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "CHODAKIEWITZ",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-553-3379",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A38243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A382430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "jacob chodakiewitz md",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "jacob chodakiewitz md",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dilasha S Neupane, MD
• Sanju Neupane, NURSE PRACTITIONER
• Neuro Consulting Inc
• Neuro Healthcare Diagnostic Inc
• Neuro Integrity Incorporated
• Neurohealth Diagnostics, Inc
• Neurology & Rehabilitation Medical Group
• Neurology and Cognitive Neuroscience Institute, Inc.
• Neurology of California PC
• Neurology Pediatric Neurology

• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.