| Arise Psychiatric Medical Group Inc | |
|
1500 Haggin Oaks Blvd Ste 202 Bakersfield CA 93311-1333 | |
| (661) 735-3887 | |
| (661) 836-5545 |
| Full Name | Arise Psychiatric Medical Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1500 Haggin Oaks Blvd Ste 202, Bakersfield, California |
| Authorized Official Name and Position | Kingwai Lui (PRESIDENT) |
| Authorized Official Contact | 6266960880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arise Psychiatric Medical Group Inc 8200 Stockdale Hwy Suite M10 Box 329 Bakersfield CA 93311 Ph: (949) 466-5666 | Arise Psychiatric Medical Group Inc 1500 Haggin Oaks Blvd Ste 202 Bakersfield CA 93311-1333 Ph: (661) 735-3887 |
| NPI Number | 1972183648 |
|---|---|
| Provider Enumeration Date | 04/08/2021 |
| Last Update Date | 04/08/2021 |
| Certification Date | 04/08/2021 |
| Medicare PECOS PAC ID | 6709286677 |
|---|---|
| Medicare Enrollment ID | O20210615000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972183648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Albert U Ma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275596496 PECOS PAC ID: 1254332364 Enrollment ID: I20070116000259 |
| Provider Name | Kingwai Lui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639584220 PECOS PAC ID: 6406148121 Enrollment ID: I20181011000669 |
| Provider Name | Joseph Jacob Mazzullo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023599230 PECOS PAC ID: 0143641423 Enrollment ID: I20200625001619 |
| Provider Name | Setare Eslami |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508399122 PECOS PAC ID: 5698177244 Enrollment ID: I20210706002003 |
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