| Not Applicable | |
|
7050 Parkway Dr La Mesa CA 91942-1535 | |
| (619) 291-6040 | |
| (858) 453-6149 |
| Full Name | Not Applicable |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 7050 Parkway Dr, La Mesa, California |
| Authorized Official Name and Position | Jorge Aurelio Barrera (PRESIDENT) |
| Authorized Official Contact | 6192916040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Not Applicable Po Box 1770 La Mesa CA 91944-1770 Ph: (619) 464-1165 | Not Applicable 7050 Parkway Dr La Mesa CA 91942-1535 Ph: (619) 291-6040 |
| NPI Number | 1003832296 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 01/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003832296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A-32333 (California) | Primary |
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