San Diego Neurological Disorders

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

G57014 Issued in CA

Legal business name

SAN DIEGO NEUROLOGICAL DISORDERS

Doing business as

Tyrone L Hardy MD

Practice address

5565 Grossmont Center Drive #1-119
La Mesa, CA 91942

Phone

(619) 464-3153

Fax

(619) 464-3429

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Tyrone Leslie Hardy, MDNPI 1174739460

Title

President

Phone

(619) 464-3153

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tyrone L Hardy MD Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Tyrone Leslie Hardy, MD

  • Neurological Surgery Physician
  • La Mesa, CA
  • NPI 1174739460
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962574715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DRIVE #1-119",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-464-3153",
            "fax_number": "619-464-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DRIVE #1-119",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-464-3153",
            "fax_number": "619-464-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO NEUROLOGICAL DISORDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-464-3153",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G57014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ56955Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G570140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tyrone L Hardy MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• San Diego Hospitalist Network, a.P.C.
• San Diego Neurosurgery and Spine Institute
• San Diego OB GYN Hospitalists Inc
• San Diego Psychotherapy Group, Inc.
• San Diego Urological Medical Group
• San Diego Wellness and Recovery

• Neurological Surgery Physician in La Mesa, CA
• Providers in La Mesa, 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 Aug 22, 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.