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4667 Macarthur Blvd 320 Newport Beach CA 92660-1817 | |
| (949) 300-1952 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 4667 Macarthur Blvd, Newport Beach, California |
| Authorized Official Name and Position | Paul Depompo (CEO) |
| Authorized Official Contact | 9493001952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2549 Eastbluff Dr Ste B 253 Newport Beach CA 92660-3599 Ph: (949) 300-1952 | 4667 Macarthur Blvd 320 Newport Beach CA 92660-1817 Ph: (949) 300-1952 |
| NPI Number | 1053655720 |
|---|---|
| Provider Enumeration Date | 11/20/2012 |
| Last Update Date | 10/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053655720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY21596 (California) | Primary |
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