| 3prong | |
|
1375 Burlingame Ave Ste L2 Burlingame CA 94010-4131 | |
| (510) 952-1190 | |
| (510) 972-5976 |
| Full Name | 3prong |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1375 Burlingame Ave Ste L2, Burlingame, California |
| Authorized Official Name and Position | Deepak Kumar (CEO) |
| Authorized Official Contact | 5109521190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 3prong 39159 Paseo Padre Pkwy Ste 121 Fremont CA 94538-1600 Ph: (510) 952-1190 | 3prong 1375 Burlingame Ave Ste L2 Burlingame CA 94010-4131 Ph: (510) 952-1190 |
| NPI Number | 1598497224 |
|---|---|
| Provider Enumeration Date | 06/30/2022 |
| Last Update Date | 06/30/2022 |
| Certification Date | 06/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598497224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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