Organization
PREMIER BRAIN & SPINE INSTITUTE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD RUSTAMZADEH M.D. (PRESIDENT)
(650) 319-5559
Entity
Organization
Contact information
Practice address
393 BLOSSOM HILL RD STE 295, SAN JOSE, CA 95123-1654
(408) 540-6861
(408) 540-6865
Mailing address
393 BLOSSOM HILL RD STE 295, SAN JOSE, CA 95123-1654
(408) 540-6861
(408) 540-6865
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A90229
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275588105
NPI TYPE 2
CA
01
—
1861453318
NPI
CA
Enumeration date
05/22/2006
Last updated
12/19/2023
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