| |
8337 Telegraph Rd Ste 300 Pico Rivera CA 90660-4957 | |
(562) 467-5440 | |
(562) 467-5553 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 8337 Telegraph Rd Ste 300, Pico Rivera, California |
Authorized Official Name and Position | Tracy Ginter (DIRECTOR OF STATE OPERATIONS) |
Authorized Official Contact | 6574659497 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8337 Telegraph Rd Ste 115 Pico Rivera CA 90660-4940 Ph: (562) 467-5440 | 8337 Telegraph Rd Ste 300 Pico Rivera CA 90660-4957 Ph: (562) 467-5440 |
NPI Number | 1386785186 |
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Provider Enumeration Date | 02/12/2007 |
Last Update Date | 06/03/2024 |
Certification Date | 06/03/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386785186 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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