| Porter Ranch Psychiatric Medical Corporation | |
|
18250 Roscoe Blvd Ste 245 Northridge CA 91325-4248 | |
| (818) 527-1288 | |
| (818) 812-9025 |
| Full Name | Porter Ranch Psychiatric Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 18250 Roscoe Blvd Ste 245, Northridge, California |
| Authorized Official Name and Position | Raj Kamat (BILLER) |
| Authorized Official Contact | 8185271288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Porter Ranch Psychiatric Medical Corporation Po Box 7008 Northridge CA 91327-7008 Ph: (818) 527-1288 | Porter Ranch Psychiatric Medical Corporation 18250 Roscoe Blvd Ste 245 Northridge CA 91325-4248 Ph: (818) 527-1288 |
| NPI Number | 1962683268 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 01/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962683268 | NPI | - | NPPES |
| 00A322501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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