Individual | |
12966 Euclid St Suite 280 Garden Grove CA 92840-5200 | |
(714) 823-4770 | |
(714) 823-4777 |
Full Name | Individual |
---|---|
Speciality | Community/behavioral Health |
Location | 12966 Euclid St, Garden Grove, California |
Authorized Official Name and Position | Mabel Vasquez (INTERN) |
Authorized Official Contact | 6264286916 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Individual 12966 Euclid St Suite 280 Garden Grove CA 92840-5200 Ph: (714) 823-4770 | Individual 12966 Euclid St Suite 280 Garden Grove CA 92840-5200 Ph: (714) 823-4770 |
NPI Number | 1881019123 |
---|---|
Provider Enumeration Date | 02/24/2014 |
Last Update Date | 02/24/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881019123 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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