| Malcolm X Es | |
|
1731 Prince St Berkeley CA 94703-2464 | |
| (510) 559-3009 | |
| (510) 559-3069 |
| Full Name | Malcolm X Es |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1731 Prince St, Berkeley, California |
| Authorized Official Name and Position | Stephanie Hochman (PROGRAM DIRECTOR) |
| Authorized Official Contact | 5105593012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Malcolm X Es 171 Carlos Dr San Rafael CA 94903-2005 Ph: (510) 559-3009 | Malcolm X Es 1731 Prince St Berkeley CA 94703-2464 Ph: (510) 559-3009 |
| NPI Number | 1982907655 |
|---|---|
| Provider Enumeration Date | 12/17/2010 |
| Last Update Date | 06/17/2020 |
| Certification Date | 06/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982907655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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