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3220 S Higuera St Ste 205 San Luis Obispo CA 93401-6998 | |
| (805) 549-0169 | |
| (805) 549-0885 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3220 S Higuera St Ste 205, San Luis Obispo, California |
| Authorized Official Name and Position | Mark David Levine (PRESIDENT) |
| Authorized Official Contact | 9165767898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2081 Arena Blvd Ste 160 Sacramento CA 95834-2309 Ph: (916) 576-7898 | 3220 S Higuera St Ste 205 San Luis Obispo CA 93401-6998 Ph: (805) 549-0169 |
| NPI Number | 1801105481 |
|---|---|
| Provider Enumeration Date | 09/30/2010 |
| Last Update Date | 04/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801105481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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