| Pacific Mind Spa | |
|
4840 Mindora Dr Torrance CA 90505-2140 | |
| (562) 279-0180 | |
| (507) 262-3948 |
| Full Name | Pacific Mind Spa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4840 Mindora Dr, Torrance, California |
| Authorized Official Name and Position | Joshua Mark Flatow (OWNER) |
| Authorized Official Contact | 5622790180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Mind Spa 4840 Mindora Dr Torrance CA 90505-2140 Ph: (562) 279-0180 | Pacific Mind Spa 4840 Mindora Dr Torrance CA 90505-2140 Ph: (562) 279-0180 |
| NPI Number | 1659970333 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 11/12/2021 |
| Certification Date | 11/12/2021 |
| Medicare PECOS PAC ID | 6507273059 |
|---|---|
| Medicare Enrollment ID | O20210329001683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659970333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Joshua Mark Flatow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487996302 PECOS PAC ID: 9335434430 Enrollment ID: I20160829002196 |
| Provider Name | Veronica Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144778200 PECOS PAC ID: 2668750001 Enrollment ID: I20161104001930 |
| Provider Name | Lily L Yu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629453477 PECOS PAC ID: 3476975467 Enrollment ID: I20200619002166 |
| Provider Name | Veronica Vilas Calkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851728273 PECOS PAC ID: 3870900129 Enrollment ID: I20210401002364 |
| Provider Name | Bahareh Saidian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144236936 PECOS PAC ID: 4880083708 Enrollment ID: I20211116000446 |
| Provider Name | Esther Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376200873 PECOS PAC ID: 3870975402 Enrollment ID: I20220729000577 |
| Provider Name | Kali Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386116119 PECOS PAC ID: 5597135335 Enrollment ID: I20230112000530 |
| Provider Name | Nazish Siddiqui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740745173 PECOS PAC ID: 7517206766 Enrollment ID: I20230608002061 |
| Provider Name | Gol Ara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780180687 PECOS PAC ID: 3375891211 Enrollment ID: I20240429001598 |
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