Organization
BRAIN LONGEVITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORNE SHELDON LABEL M.D. (MEDICAL DIRECTOR)
(805) 497-4500
Entity
Organization
Contact information
Practice address
2100 LYNN RD STE 230, THOUSAND OAKS, CA 91360-8035
(805) 497-4500
(805) 495-1717
Mailing address
2100 LYNN RD STE 230, THOUSAND OAKS, CA 91360-8035
(805) 497-4500
(805) 495-1717
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G47623
CA
Other
Enumeration date
05/02/2007
Last updated
07/25/2007
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