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Organization
PSF NEUROLOGY
Active
Organization
PSF NEUROLOGY
Active
Parent organization
PEDIATRIC SUBSPECIALTY FACULTY, INC.
Other names
Pediatric Subspecialty Faculty, Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC SUBSPECIALTY FACULTY, INC.
Authorized official
ELIZABETH M FARACE (BILLING MANAGER)
(714) 516-4295
Entity
Organization
Contact information
Practice address
455 S MAIN ST, ORANGE, CA 92868-3835
(714) 516-4295
Mailing address
455 S MAIN ST, ORANGE, CA 92868-3835
(714) 516-4295
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090398
—
CA
05
—
GR009039E
—
CA
05
—
GR009039M
—
CA
05
—
GR009039N
—
CA
Enumeration date
07/26/2007
Last updated
02/25/2008
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