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1025 S Anaheim Blvd Anaheim CA 92805-5806 | |
| (714) 533-6220 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1025 S Anaheim Blvd, Anaheim, California |
| Authorized Official Name and Position | John R Collins (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7149533652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1301 N Tustin Ave Santa Ana CA 92705-8619 Ph: (714) 953-3500 | 1025 S Anaheim Blvd Anaheim CA 92805-5806 Ph: (714) 533-6220 |
| NPI Number | 1457470700 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 06/22/2016 |
| Medicare PECOS PAC ID | 5799748133 |
|---|---|
| Medicare Enrollment ID | O20090327000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457470700 | NPI | - | NPPES |
| HSM30594J | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 060000117 (California) | Primary |
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