| Aegis Psychiatry | |
|
4225 Executive Sq Ste 600 La Jolla CA 92037-1484 | |
| (858) 866-8444 | |
| Not Available |
| Full Name | Aegis Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4225 Executive Sq Ste 600, La Jolla, California |
| Authorized Official Name and Position | Ryan Wang (OWNER) |
| Authorized Official Contact | 8588668444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aegis Psychiatry Po Box 1770 La Mesa CA 91944-1770 Ph: (858) 866-8444 | Aegis Psychiatry 4225 Executive Sq Ste 600 La Jolla CA 92037-1484 Ph: (858) 866-8444 |
| NPI Number | 1073148680 |
|---|---|
| Provider Enumeration Date | 03/04/2020 |
| Last Update Date | 03/23/2020 |
| Certification Date | 03/23/2020 |
| Medicare PECOS PAC ID | 0244660728 |
|---|---|
| Medicare Enrollment ID | O20200423003489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073148680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ryan Y Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770960668 PECOS PAC ID: 3173880762 Enrollment ID: I20190906002197 |
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