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Organization
NEUROVASCULAR MEDICAL GROUP, INC
Active
Organization
NEUROVASCULAR MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL HIGASHIDA MD (DIRECTOR)
(415) 353-1863
Entity
Organization
Contact information
Practice address
505 PARNASSUS AVE, L352, SAN FRANCISCO, CA 94143-2204
(415) 353-1863
(415) 353-8606
Mailing address
DEPT LA 23407, PASADENA, CA 91185-0001
(415) 353-1863
(415) 353-8606
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0026390
—
CA
Enumeration date
06/02/2006
Last updated
05/14/2009
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