| Crownview Medical Group, Inc | |
|
158 C Ave Coronado CA 92118-1420 | |
| (619) 435-5400 | |
| (619) 435-5401 |
| Full Name | Crownview Medical Group, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 158 C Ave, Coronado, California |
| Authorized Official Name and Position | Mark Melden (OWNER) |
| Authorized Official Contact | 6194355400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crownview Medical Group, Inc 158 C Ave Coronado CA 92118-1420 Ph: (619) 435-5400 | Crownview Medical Group, Inc 158 C Ave Coronado CA 92118-1420 Ph: (619) 435-5400 |
| NPI Number | 1598928798 |
|---|---|
| Provider Enumeration Date | 07/08/2008 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 2668524323 |
|---|---|
| Medicare Enrollment ID | O20090710000453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598928798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Mark Melden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982653135 PECOS PAC ID: 4981693462 Enrollment ID: I20040510001023 |
| Provider Name | Christina Lam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700171436 PECOS PAC ID: 8729377726 Enrollment ID: I20160513001983 |
| Provider Name | Anne L Cox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467428268 PECOS PAC ID: 2668423153 Enrollment ID: I20161118001377 |
| Provider Name | Kathryn Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609140003 PECOS PAC ID: 8628311248 Enrollment ID: I20190523001085 |
Mark Melden, Do Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 158 C Ave, Coronado, CA 92118 Phone: 619-435-5400 Fax: 619-435-5401 | |
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