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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