Organization
MEMORY AND MOVEMENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SARANG TATIMATLA (PRESIDENT)
(650) 750-6576
Entity
Organization
Contact information
Practice address
200 NEWPORT CENTER DR STE 303, NEWPORT BEACH, CA 92660-7504
(650) 750-6576
Mailing address
200 NEWPORT CENTER DR STE 303, NEWPORT BEACH, CA 92660-7504
(650) 750-6576
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
207N00000X
Dermatology Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
2086S0105X
Surgery of the Hand (Surgery) Physician
—
—
2251G0304X
Geriatric Physical Therapist
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/27/2025
Last updated
09/09/2025
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