| Edelman-palisades Chs | |
|
15777 Bowdoin St Pacific Palisades CA 90272-3523 | |
| (310) 482-3200 | |
| (310) 915-8579 |
| Full Name | Edelman-palisades Chs |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 15777 Bowdoin St, Pacific Palisades, California |
| Authorized Official Name and Position | Lisa H. Wong (ACTING DIRECTOR) |
| Authorized Official Contact | 2137384601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edelman-palisades Chs 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Edelman-palisades Chs 15777 Bowdoin St Pacific Palisades CA 90272-3523 Ph: (310) 482-3200 |
| NPI Number | 1396202438 |
|---|---|
| Provider Enumeration Date | 02/25/2019 |
| Last Update Date | 09/06/2022 |
| Certification Date | 09/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396202438 | NPI | - | NPPES |
| 1923A | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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