Provider Demographics
NPI:1215122577
Name:CENTRAL CALIFORNIA NEUROLOGY MEDICAL CORPORATION
Entity type:Organization
Organization Name:CENTRAL CALIFORNIA NEUROLOGY MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-757-5149
Mailing Address - Street 1:256-A SAN JOSE ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901
Mailing Address - Country:US
Mailing Address - Phone:831-757-5149
Mailing Address - Fax:831-757-5140
Practice Address - Street 1:256-A SAN JOSE STREET
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-757-5149
Practice Address - Fax:831-757-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG627622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG62762Medicaid
CA00G627620Medicare PIN
CAE80042Medicare UPIN
CAG62762Medicaid