| |
20725 Rockcroft Dr Malibu CA 90265-5343 | |
(310) 317-9233 | |
(310) 943-0438 |
Full Name | |
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Speciality | Psychiatry & Neurology - Addiction Psychiatry |
Location | 20725 Rockcroft Dr, Malibu, California |
Authorized Official Name and Position | Cheryl Maplesden (SR DIRECTOR RCM) |
Authorized Official Contact | 6155103078 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 671387 Dallas TX 75267-1387 Ph: (615) 567-7282 | 20725 Rockcroft Dr Malibu CA 90265-5343 Ph: (310) 317-9233 |
NPI Number | 1457899494 |
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Provider Enumeration Date | 02/10/2017 |
Last Update Date | 02/10/2017 |
Identifier | Type | State | Issuer |
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1457899494 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0802X | Psychiatry & Neurology - Addiction Psychiatry | 20A13416 (California) | Primary |
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