| 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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