Organization
CALIFORNIA BRAIN INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN MORTAZAVI MD (PRESIDENT)
(602) 810-7403
Entity
Organization
Contact information
Practice address
2100 LYNN RD STE 120, THOUSAND OAKS, CA 91360-8033
(805) 795-7656
(805) 618-1501
Mailing address
3435 E THOUSAND OAKS BLVD, 3789, WESTLAKE VILLAGE, CA 91359-7901
(805) 795-7656
(805) 494-8621
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A112672
CA
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
12/30/2015
Last updated
05/02/2017
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