| Deep Waters Psychiatric Medical Group, Inc. | |
|
9531 Pittsburgh Ave Rancho Cucamonga CA 91730-6008 | |
| (909) 256-8360 | |
| Not Available |
| Full Name | Deep Waters Psychiatric Medical Group, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 9531 Pittsburgh Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Carolyn Annelle Maurer (CORPORATE SECRETARY) |
| Authorized Official Contact | 8889847888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep Waters Psychiatric Medical Group, Inc. Po Box 11387 San Bernardino CA 92423-1387 Ph: (888) 984-7888 | Deep Waters Psychiatric Medical Group, Inc. 9531 Pittsburgh Ave Rancho Cucamonga CA 91730-6008 Ph: (909) 256-8360 |
| NPI Number | 1770024119 |
|---|---|
| Provider Enumeration Date | 03/18/2017 |
| Last Update Date | 03/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770024119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (California) | Primary |
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