| Image Transformation Institute | |
|
1343 Stratford Ct Del Mar CA 92014-2327 | |
| (626) 429-4945 | |
| (858) 724-3585 |
| Full Name | Image Transformation Institute |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1343 Stratford Ct, Del Mar, California |
| Authorized Official Name and Position | Robert Michael Miller (PRESIDENT) |
| Authorized Official Contact | 6264294945 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Image Transformation Institute 1111 Klish Way Del Mar CA 92014-2633 Ph: (626) 676-5942 | Image Transformation Institute 1343 Stratford Ct Del Mar CA 92014-2327 Ph: (626) 429-4945 |
| NPI Number | 1376572438 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 06/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376572438 | NPI | - | NPPES |
| WCP20630A | Other | CA | PPIN FOR ROBERT MILLER CP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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