| Bold Health Medical Group | |
|
561 Saxony Pl Ste 101 Encinitas CA 92024-7700 | |
| (760) 503-5703 | |
| Not Available |
| Full Name | Bold Health Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 561 Saxony Pl Ste 101, Encinitas, California |
| Authorized Official Name and Position | Kathryn Papier Hirst (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 7605034703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bold Health Medical Group 561 Saxony Pl Ste 101 Encinitas CA 92024-7700 Ph: () - | Bold Health Medical Group 561 Saxony Pl Ste 101 Encinitas CA 92024-7700 Ph: (760) 503-5703 |
| NPI Number | 1245749688 |
|---|---|
| Provider Enumeration Date | 09/28/2017 |
| Last Update Date | 10/13/2022 |
| Certification Date | 10/13/2022 |
| Medicare PECOS PAC ID | 9638570716 |
|---|---|
| Medicare Enrollment ID | O20210627000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245749688 | NPI | - | NPPES |
| Provider Name | Kathryn P Hirst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053452664 PECOS PAC ID: 3577600378 Enrollment ID: I20091028000088 |
| Provider Name | Mariel L. Janowsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386039188 PECOS PAC ID: 9537434105 Enrollment ID: I20171006002056 |
| Provider Name | Katelyn Brady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952797540 PECOS PAC ID: 2062754054 Enrollment ID: I20190423000592 |
| Provider Name | Armine Hakopyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831786896 PECOS PAC ID: 8628444718 Enrollment ID: I20221013003552 |
| Provider Name | David J Printz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679667844 PECOS PAC ID: 9436117025 Enrollment ID: I20230104002099 |
| Provider Name | Scott M Phillips |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1861875072 PECOS PAC ID: 5193175081 Enrollment ID: I20231218004330 |
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