| Innovative Psychiatric Services Corp. | |
|
1272 Center Court Dr Ste 104 Covina CA 91724-3667 | |
| (909) 268-5906 | |
| Not Available |
| Full Name | Innovative Psychiatric Services Corp. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1272 Center Court Dr Ste 104, Covina, California |
| Authorized Official Name and Position | Daniel Thomas Suzuki (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9092685906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Psychiatric Services Corp. 1272 Center Court Dr Ste 104 Covina CA 91724-3667 Ph: (909) 268-5906 | Innovative Psychiatric Services Corp. 1272 Center Court Dr Ste 104 Covina CA 91724-3667 Ph: (909) 268-5906 |
| NPI Number | 1366149973 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 02/14/2023 |
| Certification Date | 02/14/2023 |
| Medicare PECOS PAC ID | 4284091919 |
|---|---|
| Medicare Enrollment ID | O20230612000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366149973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | David Paul Suzuki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952059560 PECOS PAC ID: 5597134163 Enrollment ID: I20221205000832 |
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