| Bstmd, Incorporated | |
|
3585 Maple St Suite # 205 Ventura CA 93003-3504 | |
| (805) 654-0926 | |
| (805) 654-0949 |
| Full Name | Bstmd, Incorporated |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 3585 Maple St, Ventura, California |
| Authorized Official Name and Position | Brian S Taylor (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8056540926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bstmd, Incorporated 3585 Maple St Suite # 205 Ventura CA 93003-3504 Ph: (805) 654-0926 | Bstmd, Incorporated 3585 Maple St Suite # 205 Ventura CA 93003-3504 Ph: (805) 654-0926 |
| NPI Number | 1205245495 |
|---|---|
| Provider Enumeration Date | 08/13/2014 |
| Last Update Date | 08/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205245495 | NPI | - | NPPES |
| G75540 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | G75540 (California) | Primary |
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