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4995 Murphy Canyon Rd Ste 201 San Diego CA 92123-4365 | |
| (619) 276-8112 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4995 Murphy Canyon Rd Ste 201, San Diego, California |
| Authorized Official Name and Position | Bob Marchetti (CFO) |
| Authorized Official Contact | 6192750822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 421141 San Diego CA 92142-1141 Ph: (619) 276-8112 | 4995 Murphy Canyon Rd Ste 201 San Diego CA 92123-4365 Ph: (619) 276-8112 |
| NPI Number | 1568893212 |
|---|---|
| Provider Enumeration Date | 12/06/2013 |
| Last Update Date | 07/10/2024 |
| Certification Date | 07/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568893212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 37B7 (California) | Primary |
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