| Mark T. Gmoser, Psy.d., A Psychological Corporation | |
|
7907 Cherrystone Ave Panorama City CA 91402-6105 | |
| (818) 821-0095 | |
| Not Available |
| Full Name | Mark T. Gmoser, Psy.d., A Psychological Corporation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7907 Cherrystone Ave, Panorama City, California |
| Authorized Official Name and Position | Mark Thomas Gmoser (PESIDENT) |
| Authorized Official Contact | 8188210095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark T. Gmoser, Psy.d., A Psychological Corporation Po Box 5306 Sherman Oaks CA 91413-5306 Ph: (818) 821-0095 | Mark T. Gmoser, Psy.d., A Psychological Corporation 7907 Cherrystone Ave Panorama City CA 91402-6105 Ph: (818) 821-0095 |
| NPI Number | 1750933214 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 07/18/2019 |
| Medicare PECOS PAC ID | 6002240165 |
|---|---|
| Medicare Enrollment ID | O20191223002078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750933214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mark T Gmoser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861662702 PECOS PAC ID: 7911331087 Enrollment ID: I20191223002109 |
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