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7917 Ostrow St Ste A San Diego CA 92111-3604 | |
| (858) 300-8282 | |
| (858) 300-8284 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7917 Ostrow St Ste A, 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 |
|---|---|
7917 Ostrow St Ste A San Diego CA 92111-3604 Ph: (858) 300-8282 | 7917 Ostrow St Ste A San Diego CA 92111-3604 Ph: (858) 300-8282 |
| NPI Number | 1689897100 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 07/29/2021 |
| Certification Date | 07/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689897100 | NPI | - | NPPES |
| 37H5 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 37H5 (California) | Primary |
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