| Amhs Pact Fullerton | |
|
401 E. Imperial Hwy Fullerton CA 92835-1145 | |
| (714) 447-7000 | |
| Not Available |
| Full Name | Amhs Pact Fullerton |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 401 E. Imperial Hwy, Fullerton, California |
| Authorized Official Name and Position | Chi Y Rajalingam (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 7148343154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amhs Pact Fullerton 405 W 5th St Ste 212 Santa Ana CA 92701-4522 Ph: (714) 568-5614 | Amhs Pact Fullerton 401 E. Imperial Hwy Fullerton CA 92835-1145 Ph: (714) 447-7000 |
| NPI Number | 1316084031 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316084031 | NPI | - | NPPES |
| 3007 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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