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5333 Mission Center Rd Ste 105 San Diego CA 92108-1347 | |
| (619) 997-4510 | |
| (619) 984-5440 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5333 Mission Center Rd Ste 105, San Diego, California |
| Authorized Official Name and Position | Bob Marchetti (CFO) |
| Authorized Official Contact | 6192750822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5333 Mission Center Rd Ste 105 San Diego CA 92108-1347 Ph: (619) 997-4510 | 5333 Mission Center Rd Ste 105 San Diego CA 92108-1347 Ph: (619) 997-4510 |
| NPI Number | 1871365684 |
|---|---|
| Provider Enumeration Date | 10/25/2023 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871365684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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