# OC NEUROLOGY CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265986145
- **Authorized official:** DR. NASER M ELBALALESY M.D. (PRESIDENT)
- **Authorized official phone:** (949) 837-7322

## Contact information

- **Practice address:** 17822 BEACH BLVD, \# 374, HUNTINGTON BEACH, CA 92647-7101
- **Practice address phone:** (714) 848-3333
- **Practice address fax:** (714) 848-3301
- **Mailing address:** 139 VIA ATHENA, ALISO VIEJO, CA 92656-1612
- **Mailing address phone:** (949) 837-7322
- **Mailing address fax:** (714) 848-3301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A73709 | CA | Yes |

## Other

- **Enumeration date:** 08/09/2016
- **Last updated:** 08/09/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00A737090 | MEDICAL/MEDICARE | CA |