Provider Demographics
NPI:1548463441
Name:THE EPILEPSY CLINICS OF S. CAL
Entity type:Organization
Organization Name:THE EPILEPSY CLINICS OF S. CAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:949-645-5999
Mailing Address - Street 1:3535 E. COAST HWY #332
Mailing Address - Street 2:ATTN MAIL ROOM
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625
Mailing Address - Country:US
Mailing Address - Phone:949-645-5999
Mailing Address - Fax:949-223-4237
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:STE 331
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663
Practice Address - Country:US
Practice Address - Phone:949-645-5999
Practice Address - Fax:949-223-4237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084N0400X
CAG0467692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0G0467690Medicaid
CAA92674Medicare UPIN
CAG46769AMedicare ID - Type UnspecifiedMEDICARE
CA0G0467690Medicaid