| Brightline Medical Associates, Inc. | |
|
90 Middlefield Rd Menlo Park CA 94025-4001 | |
| (650) 646-5697 | |
| Not Available |
| Full Name | Brightline Medical Associates, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 90 Middlefield Rd, Menlo Park, California |
| Authorized Official Name and Position | David Grodberg (PRESIDENT) |
| Authorized Official Contact | 9175870024 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brightline Medical Associates, Inc. 175 Forest Ave Palo Alto CA 94301-1615 Ph: (650) 799-1746 | Brightline Medical Associates, Inc. 90 Middlefield Rd Menlo Park CA 94025-4001 Ph: (650) 646-5697 |
| NPI Number | 1003424870 |
|---|---|
| Provider Enumeration Date | 07/17/2020 |
| Last Update Date | 07/17/2020 |
| Certification Date | 07/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003424870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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