Blockdare Inc | |
2260 Brentford Rd San Marino CA 91108-2801 | |
(626) 429-3651 | |
Not Available |
Full Name | Blockdare Inc |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 2260 Brentford Rd, San Marino, California |
Authorized Official Name and Position | Stella M Abrahan (SUPERVISOR) |
Authorized Official Contact | 6264293651 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Blockdare Inc 2260 Brentford Rd San Marino CA 91108-2801 Ph: (626) 429-3651 | Blockdare Inc 2260 Brentford Rd San Marino CA 91108-2801 Ph: (626) 429-3651 |
NPI Number | 1205241163 |
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Provider Enumeration Date | 06/29/2014 |
Last Update Date | 06/29/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205241163 | NPI | - | NPPES |
M015046 | Other | CA | NONE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0855X | Clinic/center - Adolescent And Children Mental Health | 0M15046 (California) | Primary |
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