| Edmund D. Edelman Westside Mhc | |
|
5860 Uplander Way Culver City CA 90230-6608 | |
| (310) 966-6500 | |
| (310) 313-0813 |
| Full Name | Edmund D. Edelman Westside Mhc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5860 Uplander Way, Culver City, California |
| Authorized Official Name and Position | Lisa H. Wong (DIRECTOR) |
| Authorized Official Contact | 2137384601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edmund D. Edelman Westside Mhc 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Edmund D. Edelman Westside Mhc 5860 Uplander Way Culver City CA 90230-6608 Ph: (310) 966-6500 |
| NPI Number | 1992738520 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 06/20/2024 |
| Certification Date | 06/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992738520 | NPI | - | NPPES |
| 1906 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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