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147 El Levante San Clemente CA 92672-3138 | |
| (603) 966-8389 | |
| (949) 606-8518 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 147 El Levante, San Clemente, California |
| Authorized Official Name and Position | Timothy Doolin (CFO) |
| Authorized Official Contact | 8882381038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
34145 Pacific Coast Hwy # 800 Dana Point CA 92629-2808 Ph: () - | 147 El Levante San Clemente CA 92672-3138 Ph: (603) 966-8389 |
| NPI Number | 1790332344 |
|---|---|
| Provider Enumeration Date | 08/19/2019 |
| Last Update Date | 03/08/2023 |
| Certification Date | 03/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790332344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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