| Roula Creighton Md, Inc | |
|
4199 Campus Dr Ste 550 Irvine CA 92612-4694 | |
| (949) 271-9533 | |
| (949) 437-3428 |
| Full Name | Roula Creighton Md, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4199 Campus Dr Ste 550, Irvine, California |
| Authorized Official Name and Position | Roula Creighton (PRESIDENT) |
| Authorized Official Contact | 9492027566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roula Creighton Md, Inc 4199 Campus Dr Ste 550 Irvine CA 92612-4694 Ph: (949) 202-7566 | Roula Creighton Md, Inc 4199 Campus Dr Ste 550 Irvine CA 92612-4694 Ph: (949) 271-9533 |
| NPI Number | 1801468012 |
|---|---|
| Provider Enumeration Date | 07/15/2021 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Medicare PECOS PAC ID | 9032591474 |
|---|---|
| Medicare Enrollment ID | O20220802002942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801468012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Roula Creighton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821142373 PECOS PAC ID: 3274603360 Enrollment ID: I20080602000173 |
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