| Facticious Business Name | |
|
468 N Camden Dr Ste 353 Beverly Hills CA 90210-4507 | |
| (310) 601-3074 | |
| Not Available |
| Full Name | Facticious Business Name |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 468 N Camden Dr Ste 353, Beverly Hills, California |
| Authorized Official Name and Position | Seniora Matthews (CEO/MEDICAL DIRECTOR) |
| Authorized Official Contact | 3106013074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Facticious Business Name 468 N Camden Dr Ste 353 Beverly Hills CA 90210-4507 Ph: (301) 601-3074 | Facticious Business Name 468 N Camden Dr Ste 353 Beverly Hills CA 90210-4507 Ph: (310) 601-3074 |
| NPI Number | 1871809822 |
|---|---|
| Provider Enumeration Date | 08/27/2010 |
| Last Update Date | 06/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871809822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A93922 (California) | Primary |
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