Kaizen Brain Center

Primary specialty

Brain Injury Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P0301X

License

A124696 Issued in CA

Legal business name

KAIZEN BRAIN CENTER

Practice address

4510 Executive Dr
Suite 107
San Diego, CA 92121-3021

Phone

(949) 295-6693

Fax

(858) 779-2511

NPI assigned

Dec 30, 2016

Organization subpart

No

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

Authorized official

Name

Mohammed Muzammil Ahmed, M.D.

Title

Director

Phone

(866) 277-2659

Specialties & licenses 2

Addresses

Other names 1

• Memory Concussion Center Former legal business name

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1891230868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9247 PIATTO LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084767",
            "telephone_number": "949-295-6693",
            "fax_number": "858-779-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR",
            "address_2": "SUITE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213021",
            "telephone_number": "949-295-6693",
            "fax_number": "858-779-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIZEN BRAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-30",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "MUZAMMIL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "866-277-2659",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "CA",
            "license": "A124696",
            "primary": false
        },
        {
            "code": "2084P0301X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": "CA",
            "license": "A124696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memory Concussion Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Katelyn Kaiser
• Sabrina Marie Kaiser, LMFT
• Sophia Anne Kaiser
• Wendy Weatherstone Kaiser, MFT
• Max Takuya Kaito, MD
• Stephen T Kajdasz, MD
• Divya Kakaiya, PH.D, M.S.
• Saketh Kakarla
• Nathan Firas Kakish
• Agni Kakouri, MD

• Brain Injury Medicine (Psychiatry & Neurology) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Brain Injury Medicine (Psychiatry & Neurology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.