Neuro Care of Tarzana Medical Clinic, Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A78516 Issued in CA

Legal business name

NEURO CARE OF TARZANA MEDICAL CLINIC, INC

Practice address

18344 Clark St Suite # 208
Tarzana, CA 91356-3505

Phone

(818) 342-1515

Fax

(818) 342-0500

NPI assigned

Jan 1, 2007

Last updated

Aug 19, 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

Dr. Deepak Kumar Chugh, MD

Title

President and Ceo

Phone

(818) 342-1515

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1801953955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18344 CLARK STREET SUITE # 208",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563505",
            "telephone_number": "818-342-1515",
            "fax_number": "818-342-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18344 CLARK ST SUITE # 208",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563505",
            "telephone_number": "818-342-1515",
            "fax_number": "818-342-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO CARE OF TARZANA MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-01",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "CHUGH",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "818-342-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A78516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A785160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.