Provider Demographics
NPI:1386139061
Name:CALIFORNIA CENTER FOR MS AND NEUROLOGY INC
Entity type:Organization
Organization Name:CALIFORNIA CENTER FOR MS AND NEUROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:ANZALONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-763-8768
Mailing Address - Street 1:1091 E BAYAUD AVE APT W2604
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2783
Mailing Address - Country:US
Mailing Address - Phone:415-763-8768
Mailing Address - Fax:831-603-0438
Practice Address - Street 1:21 TAMAL VISTA BLVD STE 175
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925
Practice Address - Country:US
Practice Address - Phone:415-763-8768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty