Phoenix Holistic Psychiatry Llc | |
1425 S Higley Rd Ste 104 Gilbert AZ 85296-4798 | |
(480) 470-0069 | |
Not Available |
Full Name | Phoenix Holistic Psychiatry Llc |
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Speciality | Psychiatry & Neurology |
Location | 1425 S Higley Rd Ste 104, Gilbert, Arizona |
Authorized Official Name and Position | Panchajanya Paul (OWNER) |
Authorized Official Contact | 6782508883 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Phoenix Holistic Psychiatry Llc 929 N Val Vista Dr Ste 109-130 Gilbert AZ 85234-3706 Ph: (480) 470-0069 | Phoenix Holistic Psychiatry Llc 1425 S Higley Rd Ste 104 Gilbert AZ 85296-4798 Ph: (480) 470-0069 |
NPI Number | 1174292221 |
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Provider Enumeration Date | 09/11/2021 |
Last Update Date | 10/05/2023 |
Certification Date | 10/05/2023 |
Medicare PECOS PAC ID | 1658756580 |
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Medicare Enrollment ID | O20220913003950 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174292221 | NPI | - | NPPES |
Provider Name | Panchajanya Paul |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1356664007 PECOS PAC ID: 2163646613 Enrollment ID: I20220916001973 |
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