Provider Demographics
NPI:1386615854
Name:MED-NEURO CORP
Entity type:Organization
Organization Name:MED-NEURO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST/PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANIBAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-5257
Mailing Address - Street 1:201 S ALVARADO STREET
Mailing Address - Street 2:SUITE 828
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057
Mailing Address - Country:US
Mailing Address - Phone:213-484-5257
Mailing Address - Fax:213-484-5919
Practice Address - Street 1:201 S ALVARADO STREET
Practice Address - Street 2:SUITE 828
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057
Practice Address - Country:US
Practice Address - Phone:213-484-5257
Practice Address - Fax:213-484-5919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA424862084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
130009511OtherRAILROAD MEDICARE
0004623936OtherAETNA
CAGR0067490Medicaid
CAZZZ014492OtherBLUE SHIELD
CAZZZ014492OtherBLUE SHIELD
CAGR0067490Medicaid