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Organization
CALIFORNIA NEUROINTERVENTIONAL SURGEONS, INC
Active
Organization
CALIFORNIA NEUROINTERVENTIONAL SURGEONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES STOUT MD/PHD (PRESIDENT AND CEO)
(909) 554-0400
Entity
Organization
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(951) 788-3000
Mailing address
700 E REDLANDS BLVD, STE U714, REDLANDS, CA 92373-6109
(909) 554-0400
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
02/05/2016
Last updated
07/06/2021
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