Organization
PACIFIC NEUROSCIENCE INSTITUTE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL F KELLY MD (CHAIRMAN)
(310) 477-5558
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BOULEVARD, 6TH FLOOR, LOS ANGELES, CA 90025-6807
(310) 477-5558
(310) 477-7281
Mailing address
11645 WILSHIRE BOULEVARD, 6TH FLOOR, LOS ANGELES, CA 90025-6807
(310) 477-5558
(310) 477-7281
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
FNP545334
CA
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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