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15373 Innovation Drive, Ste 395 San Diego CA 92128-3429 | |
| (858) 876-3105 | |
| (858) 876-3107 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 15373 Innovation Drive, Ste 395, San Diego, California |
| Authorized Official Name and Position | Satya V Tata (PRESIDENT) |
| Authorized Official Contact | 8588763105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15373 Innovation Drive, Ste 395 San Diego CA 92128-3429 Ph: (858) 876-3105 | 15373 Innovation Drive, Ste 395 San Diego CA 92128-3429 Ph: (858) 876-3105 |
| NPI Number | 1346628179 |
|---|---|
| Provider Enumeration Date | 05/13/2015 |
| Last Update Date | 05/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346628179 | NPI | - | NPPES |
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