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225 W Valley Pkwy Suite 100 Escondido CA 92025-2613 | |
(760) 233-0133 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 225 W Valley Pkwy, Escondido, California |
Authorized Official Name and Position | Michael Bruich (CEO) |
Authorized Official Contact | 6195430293 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 34219 San Diego CA 92163-4219 Ph: (619) 543-0293 | 225 W Valley Pkwy Suite 100 Escondido CA 92025-2613 Ph: (760) 233-0133 |
NPI Number | 1407207566 |
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Provider Enumeration Date | 06/29/2016 |
Last Update Date | 06/30/2016 |
Identifier | Type | State | Issuer |
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1407207566 | NPI | - | NPPES |
000000000 | Other | CA | NA |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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