Neu-self | |
3833 E 6th St Los Angeles CA 90023-1807 | |
(650) 457-3747 | |
Not Available |
Full Name | Neu-self |
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Speciality | Clinic/Center |
Location | 3833 E 6th St, Los Angeles, California |
Authorized Official Name and Position | Marco Antonio Torres (PRESIDENT) |
Authorized Official Contact | 6504573747 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neu-self 3833 E 6th St Los Angeles CA 90023-1807 Ph: (650) 457-3747 | Neu-self 3833 E 6th St Los Angeles CA 90023-1807 Ph: (650) 457-3747 |
NPI Number | 1134795024 |
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Provider Enumeration Date | 06/01/2021 |
Last Update Date | 04/13/2023 |
Certification Date | 04/13/2023 |
Medicare PECOS PAC ID | 3476927443 |
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Medicare Enrollment ID | O20230315001512 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134795024 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Octavio Delgado |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1083766489 PECOS PAC ID: 2466826433 Enrollment ID: I20230315001638 |
Provider Name | Larry Fernandez |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1396860938 PECOS PAC ID: 0941674824 Enrollment ID: I20230315002213 |
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