Provider Demographics
NPI:1396165205
Name:MORVARID NEUROLOGY, INC.
Entity type:Organization
Organization Name:MORVARID NEUROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORVARID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-658-4989
Mailing Address - Street 1:19100 VENTURA BLVD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3239
Mailing Address - Country:US
Mailing Address - Phone:818-342-6450
Mailing Address - Fax:
Practice Address - Street 1:19100 VENTURA BLVD
Practice Address - Street 2:SUITE 14
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3239
Practice Address - Country:US
Practice Address - Phone:818-342-6450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC556342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I72192Medicare UPIN
110176NPOMedicare PIN