| Bellator Psychological And Consultants Corporation | |
|
6117 Brockton Ave Ste 202 Riverside CA 92506-2207 | |
| (951) 224-9418 | |
| Not Available |
| Full Name | Bellator Psychological And Consultants Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 6117 Brockton Ave Ste 202, Riverside, California |
| Authorized Official Name and Position | George Dabdoub (PRESIDENT) |
| Authorized Official Contact | 9512249418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellator Psychological And Consultants Corporation 6117 Brockton Ave Ste 202 Riverside CA 92506-2207 Ph: () - | Bellator Psychological And Consultants Corporation 6117 Brockton Ave Ste 202 Riverside CA 92506-2207 Ph: (951) 224-9418 |
| NPI Number | 1962124941 |
|---|---|
| Provider Enumeration Date | 09/15/2022 |
| Last Update Date | 03/02/2023 |
| Certification Date | 03/02/2023 |
| Medicare PECOS PAC ID | 0840655015 |
|---|---|
| Medicare Enrollment ID | O20230424002067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962124941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | George Dabdoub |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730739079 PECOS PAC ID: 2466857446 Enrollment ID: I20210830002006 |
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