| Avicenna Medical And Clinical Research Institute | |
|
23166 Los Alisos Blvd Ste 108-122 Mission Viejo CA 92691-2835 | |
| (951) 666-3995 | |
| (847) 221-6847 |
| Full Name | Avicenna Medical And Clinical Research Institute |
|---|---|
| Speciality | Clinic/Center |
| Location | 23166 Los Alisos Blvd Ste 108-122, Mission Viejo, California |
| Authorized Official Name and Position | Irina Filip (PSYCHIATRIST) |
| Authorized Official Contact | 9516663995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avicenna Medical And Clinical Research Institute 23166 Los Alisos Blvd Ste 108-122 Mission Viejo CA 92691-2835 Ph: (951) 666-3995 | Avicenna Medical And Clinical Research Institute 23166 Los Alisos Blvd Ste 108-122 Mission Viejo CA 92691-2835 Ph: (951) 666-3995 |
| NPI Number | 1720744352 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 09/17/2024 |
| Certification Date | 09/17/2024 |
| Medicare PECOS PAC ID | 8527432806 |
|---|---|
| Medicare Enrollment ID | O20230328002960 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720744352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QR1100X | Clinic/center - Research | (* (Not Available)) | Secondary |
| Provider Name | Irina Filip |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801207923 PECOS PAC ID: 3072894005 Enrollment ID: I20171222000935 |
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