| Oc Teen Center Llc | |
|
3188 Airway Ave Ste L Costa Mesa CA 92626-4652 | |
| (800) 478-0233 | |
| Not Available |
| Full Name | Oc Teen Center Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 3188 Airway Ave Ste L, Costa Mesa, California |
| Authorized Official Name and Position | Jonah Bautista (OFFICE MANAGER) |
| Authorized Official Contact | 7147165044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oc Teen Center Llc 3188 Airway Ave Ste L Costa Mesa CA 92626-4652 Ph: () - | Oc Teen Center Llc 3188 Airway Ave Ste L Costa Mesa CA 92626-4652 Ph: (800) 478-0233 |
| NPI Number | 1528650686 |
|---|---|
| Provider Enumeration Date | 02/09/2021 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528650686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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