Pacific Neurology Consultants, Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A85738 Issued in CA

Legal business name

PACIFIC NEUROLOGY CONSULTANTS, INC.

Practice address

3191 Oak Knoll Dr
Los Alamitos, CA 90720-4516

Phone

(562) 365-3022

Fax

(888) 596-7302

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mohan Venkataratna Tadikonda, M.D.NPI 1326083858

Title

President

Phone

(562) 365-3022

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohan V. Tadikonda, M.D.

  • Neurology Physician
  • Los Alamitos, CA
  • NPI 1326083858
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1811023443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6007",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908060007",
            "telephone_number": "562-365-3022",
            "fax_number": "888-596-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 OAK KNOLL DR",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907204516",
            "telephone_number": "562-365-3022",
            "fax_number": "888-596-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NEUROLOGY CONSULTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "TADIKONDA",
        "authorized_official_first_name": "MOHAN",
        "authorized_official_middle_name": "VENKATARATNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-365-3022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A85738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.