| Addiction Specialist Of Southern California, Inc. | |
|
4000 Macarthur Blvd Suite 600 East Tower Newport Beach CA 92660-2517 | |
| (949) 390-4730 | |
| (949) 627-8107 |
| Full Name | Addiction Specialist Of Southern California, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4000 Macarthur Blvd, Newport Beach, California |
| Authorized Official Name and Position | Lawrence Vernon Tucker (OWNER) |
| Authorized Official Contact | 9493904730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Addiction Specialist Of Southern California, Inc. 66 English Saddle Irvine CA 92602-1839 Ph: (949) 390-4730 | Addiction Specialist Of Southern California, Inc. 4000 Macarthur Blvd Suite 600 East Tower Newport Beach CA 92660-2517 Ph: (949) 390-4730 |
| NPI Number | 1700626629 |
|---|---|
| Provider Enumeration Date | 05/29/2024 |
| Last Update Date | 05/29/2024 |
| Certification Date | 05/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700626629 | NPI | - | NPPES |
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