Organization
CALIFORNIA NEUROLOGICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOLLY BANERJEE ROY MD PHD (CEO)
(415) 377-2837
Entity
Organization
Contact information
Practice address
227 W JANSS RD STE 135, THOUSAND OAKS, CA 91360-1857
(415) 377-2837
(650) 618-0485
Mailing address
1922 GOLDEN SKY CIR, WESTLAKE VILLAGE, CA 91362-5292
(415) 377-2837
(650) 618-0485
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A86956
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W1926200
MEDICARE PTAN
CA
Enumeration date
03/16/2009
Last updated
03/16/2009
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