| Altitude Wellness | |
|
320 Pine Ave Ste 1030 Long Beach CA 90802-2366 | |
| (310) 284-2274 | |
| Not Available |
| Full Name | Altitude Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 320 Pine Ave Ste 1030, Long Beach, California |
| Authorized Official Name and Position | Dustin Stephens (OWNER/PRESIDENT) |
| Authorized Official Contact | 4243399859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Altitude Wellness 21213 Hawthorne Blvd Ste B #1101 Torrance CA 90503 Ph: (310) 284-2274 | Altitude Wellness 320 Pine Ave Ste 1030 Long Beach CA 90802-2366 Ph: (310) 284-2274 |
| NPI Number | 1235839002 |
|---|---|
| Provider Enumeration Date | 03/09/2023 |
| Last Update Date | 03/14/2023 |
| Certification Date | 03/10/2023 |
| Medicare PECOS PAC ID | 1951760172 |
|---|---|
| Medicare Enrollment ID | O20230706002870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235839002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dustin Blake Stephens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922461151 PECOS PAC ID: 2466880430 Enrollment ID: I20200325002708 |
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