| Smith & Obrien Psychiatric Group Inc | |
|
1127 Wilshire Blvd Ste 1415 Los Angeles CA 90017-4005 | |
| (800) 578-1471 | |
| Not Available |
| Full Name | Smith & Obrien Psychiatric Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1127 Wilshire Blvd Ste 1415, Los Angeles, California |
| Authorized Official Name and Position | Samuel Penney Smith (OWNER) |
| Authorized Official Contact | 3108640377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smith & Obrien Psychiatric Group Inc 1127 Wilshire Blvd Ste 1415 Los Angeles CA 90017-4005 Ph: (800) 578-1471 | Smith & Obrien Psychiatric Group Inc 1127 Wilshire Blvd Ste 1415 Los Angeles CA 90017-4005 Ph: (800) 578-1471 |
| NPI Number | 1124613849 |
|---|---|
| Provider Enumeration Date | 03/04/2021 |
| Last Update Date | 06/13/2023 |
| Certification Date | 06/13/2023 |
| Medicare PECOS PAC ID | 7214338151 |
|---|---|
| Medicare Enrollment ID | O20210629002001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124613849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Samuel P Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295802700 PECOS PAC ID: 3577477801 Enrollment ID: I20031119000433 |
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