| Mission Behavioral Health, Inc. | |
|
7672 Avalon Blvd Los Angeles CA 90003-2346 | |
| (614) 420-5957 | |
| Not Available |
| Full Name | Mission Behavioral Health, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7672 Avalon Blvd, Los Angeles, California |
| Authorized Official Name and Position | Richard Williams (CFO) |
| Authorized Official Contact | 6144205957 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Behavioral Health, Inc. 510 S Grand Ave Ste 200 Glendora CA 91741-4291 Ph: (614) 420-5957 | Mission Behavioral Health, Inc. 7672 Avalon Blvd Los Angeles CA 90003-2346 Ph: (614) 420-5957 |
| NPI Number | 1427745009 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 01/05/2024 |
| Certification Date | 01/05/2024 |
| Medicare PECOS PAC ID | 9537516885 |
|---|---|
| Medicare Enrollment ID | O20231108003503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427745009 | NPI | - | NPPES |
| Provider Name | George J Graf |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336137934 PECOS PAC ID: 0648163568 Enrollment ID: I20040210000542 |
| Provider Name | Bernard Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790405512 PECOS PAC ID: 8325482862 Enrollment ID: I20240222004088 |
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