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Organization
SOUTHERN CALIFORNIA NEURODIAGNOSTIC CENTER, INC
Active
Organization
SOUTHERN CALIFORNIA NEURODIAGNOSTIC CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY BRAYTON (OFFICE MANAGER)
(562) 495-3937
Entity
Organization
Contact information
Practice address
5212 KATELLA AVE, SUITE 106, LOS ALAMITOS, CA 90720-2828
(562) 495-3937
(562) 206-0371
Mailing address
133 THE PROMENADE N STE 108, LONG BEACH, CA 90802-4728
(562) 495-3937
(562) 206-0371
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A34249
ID
CA
Enumeration date
10/21/2005
Last updated
01/22/2015
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