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NEUROCENTER FOR PAIN AND TREMOR A MEDICAL GROUP INC NPI 1760566400


NPI Information

NPI: 1760566400
Provider Name: NEUROCENTER FOR PAIN AND TREMOR A MEDICAL GROUP INC

Doing Business As: JACOB CHODAKIEWITZ MD

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1125 S BEVERLY DR STE 610
LOS ANGELES, CA
ZIP 90035
Phone: (310) 553-3379
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NEUROCENTER FOR PAIN AND TREMOR A MEDICAL GROUP INC is a specialist in Los Angeles, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. NEUROCENTER FOR PAIN AND TREMOR A MEDICAL GROUP INC NPI is 1760566400. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Jacob Chodakiewitz Md.

The provider's business location address is:

1125 S BEVERLY DR STE 610
LOS ANGELES, CA
ZIP 90035-182
Phone: (310) 553-3379
Fax: (310) 847-9714

The provider's authorized official is Jacob W Chodakiewitz .
The authorized official title is President and has the following contact phone number (310) 553-3379.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 12/5/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistA38243CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100A382430MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.