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Organization
OC NEUROLOGY CLINIC, INC.
Active
Organization
OC NEUROLOGY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NASER M ELBALALESY M.D. (PRESIDENT)
(949) 837-7322
Entity
Organization
Contact information
Practice address
17822 BEACH BLVD, # 374, HUNTINGTON BEACH, CA 92647-7101
(714) 848-3333
(714) 848-3301
Mailing address
139 VIA ATHENA, ALISO VIEJO, CA 92656-1612
(949) 837-7322
(714) 848-3301
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A73709
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A737090
MEDICAL/MEDICARE
CA
Enumeration date
08/09/2016
Last updated
08/09/2016
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