Organization
SOUTHERN CALIFORNIA HEAD PAIN AND NEUROLOGIC INSTITUTE INC
Active
Organization
SOUTHERN CALIFORNIA HEAD PAIN AND NEUROLOGIC INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOT J RICHARDSON M.D. (OWNER)
(805) 648-3158
Entity
Organization
Contact information
Practice address
3555 LOMA VISTA RD, #115, VENTURA, CA 93003-3161
(805) 648-3158
(805) 648-2997
Mailing address
3555 LOMA VISTA RD, STE 115, VENTURA, CA 93003-3161
(805) 648-3158
(805) 648-2997
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A60878
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A60878
LICENSE
CA
01
—
W19218
MEDICARE PTAN
CA
Enumeration date
07/05/2006
Last updated
07/17/2015
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