| Sports Concussion Institute A Psychology Group Inc | |
|
5230 Pacific Concourse Dr Suite 300 Los Angeles CA 90045-6200 | |
| (310) 643-9595 | |
| (310) 643-5180 |
| Full Name | Sports Concussion Institute A Psychology Group Inc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 5230 Pacific Concourse Dr, Los Angeles, California |
| Authorized Official Name and Position | Tony L Strickland (OWNER PROVIDER) |
| Authorized Official Contact | 3106439595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sports Concussion Institute A Psychology Group Inc 5230 Pacific Concourse Drive Suite 300 Los Angeles CA 90045-6200 Ph: (310) 643-9595 | Sports Concussion Institute A Psychology Group Inc 5230 Pacific Concourse Dr Suite 300 Los Angeles CA 90045-6200 Ph: (310) 643-9595 |
| NPI Number | 1194896498 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 01/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194896498 | NPI | - | NPPES |
| ZZZ50434Y | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY12223 (California) | Primary |
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