Organization
MIAN MOHSIN SHAH AMC
Active
Other names
IRVINE NEUROLOGICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIAN MOHSIN SHAH MD (PRESIDENT AND CEO)
(714) 973-1388
Entity
Organization
Contact information
Practice address
999 N TUSTIN AVE, SUITE 109, SANTA ANA, CA 92705-3528
(714) 973-1388
(949) 284-0604
Mailing address
999 N TUSTIN AVE, SUITE 109, SANTA ANA, CA 92705-3528
(714) 973-1388
(949) 284-0604
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A066315
CA
2084N0400X
Neurology Physician
A066315
CA
2084V0102X
Vascular Neurology Physician
A066315
CA
2085R0204X
Vascular & Interventional Radiology Physician
A066315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A663150
—
CA
Enumeration date
11/04/2011
Last updated
11/04/2011
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