| Psychup Nursing Pc | |
|
11900 Avalon Blvd Ste B Los Angeles CA 90061-2866 | |
| (888) 783-1883 | |
| (888) 653-3144 |
| Full Name | Psychup Nursing Pc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 11900 Avalon Blvd Ste B, Los Angeles, California |
| Authorized Official Name and Position | Pedro Estrada Morante (CEO) |
| Authorized Official Contact | 6618880195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychup Nursing Pc 28802 Garnet Canyon Dr Santa Clarita CA 91390-5263 Ph: (661) 888-0195 | Psychup Nursing Pc 11900 Avalon Blvd Ste B Los Angeles CA 90061-2866 Ph: (888) 783-1883 |
| NPI Number | 1184326944 |
|---|---|
| Provider Enumeration Date | 03/17/2023 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Medicare PECOS PAC ID | 3577920263 |
|---|---|
| Medicare Enrollment ID | O20230612002578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184326944 | NPI | - | NPPES |
| Provider Name | Pedro Morante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689038507 PECOS PAC ID: 4385937861 Enrollment ID: I20161205002451 |
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