Organization
LA NEURO MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIO CALDERON CNIM (PARTNER)
(310) 883-4624
Entity
Organization
Contact information
Practice address
11843 DOROTHY ST APT 2, LOS ANGELES, CA 90049-4456
(424) 245-5884
Mailing address
11843 DOROTHY ST APT 2, LOS ANGELES, CA 90049-4456
(310) 883-4624
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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