| |
4141 Harbor St Pittsburg CA 94565-6156 | |
(925) 473-2440 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 4141 Harbor St, Pittsburg, California |
Authorized Official Name and Position | Donald Bruce Blasky (CHIEF PROGRAM OFFICER) |
Authorized Official Contact | 4157552311 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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11175 San Pablo Ave El Cerrito CA 94530-2157 Ph: (510) 559-3009 | 4141 Harbor St Pittsburg CA 94565-6156 Ph: (925) 473-2440 |
NPI Number | 1295350676 |
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Provider Enumeration Date | 06/11/2020 |
Last Update Date | 08/02/2021 |
Certification Date | 08/02/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295350676 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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