| Sanjai Thankachen Pa | |
|
19900 Beach Blvd Ste H Huntington Beach CA 92648-3762 | |
| (877) 538-4133 | |
| Not Available |
| Full Name | Sanjai Thankachen Pa |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 19900 Beach Blvd Ste H, Huntington Beach, California |
| Authorized Official Name and Position | Sanjai Mathew Thankachen (OWNER) |
| Authorized Official Contact | 7147824700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanjai Thankachen Pa 4681 Oceanknoll Dr Huntington Beach CA 92649-6441 Ph: (714) 782-4700 | Sanjai Thankachen Pa 19900 Beach Blvd Ste H Huntington Beach CA 92648-3762 Ph: (877) 538-4133 |
| NPI Number | 1679003834 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 06/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679003834 | NPI | - | NPPES |
| A103818 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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