| San Pedro Healing Arts Medical Clinic Inc | |
|
22706 Aspan St Suite 702 Lake Forest CA 92630-1603 | |
| (949) 427-1013 | |
| Not Available |
| Full Name | San Pedro Healing Arts Medical Clinic Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 22706 Aspan St, Lake Forest, California |
| Authorized Official Name and Position | Stephanie Fiamengo (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3105472197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Pedro Healing Arts Medical Clinic Inc 1366 W 7th St Suite 4b San Pedro CA 90732-3500 Ph: (310) 547-2197 | San Pedro Healing Arts Medical Clinic Inc 22706 Aspan St Suite 702 Lake Forest CA 92630-1603 Ph: (949) 427-1013 |
| NPI Number | 1538549563 |
|---|---|
| Provider Enumeration Date | 06/04/2015 |
| Last Update Date | 06/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538549563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PCCI 1592 (California) | Primary |
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