| Eagan Concierge Medical Group, Inc | |
|
2658 Griffith Park Blvd Ste 305 Los Angeles CA 90039-2520 | |
| (310) 702-9803 | |
| Not Available |
| Full Name | Eagan Concierge Medical Group, Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2658 Griffith Park Blvd Ste 305, Los Angeles, California |
| Authorized Official Name and Position | Breanna Splain (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 7608356880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagan Concierge Medical Group, Inc 2658 Griffith Park Blvd Ste 305 Los Angeles CA 90039-2520 Ph: () - | Eagan Concierge Medical Group, Inc 2658 Griffith Park Blvd Ste 305 Los Angeles CA 90039-2520 Ph: (310) 702-9803 |
| NPI Number | 1083296446 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 04/26/2021 |
| Certification Date | 03/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083296446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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