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 |
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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 |
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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 |
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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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