| |
323 N Prairie Ave Suite 200 Inglewood CA 90301-4502 | |
(310) 680-0560 | |
(310) 680-0565 |
Full Name | |
---|---|
Speciality | Psychiatry & Neurology |
Location | 323 N Prairie Ave, Inglewood, California |
Authorized Official Name and Position | David Kheradyar (PRESIDENT) |
Authorized Official Contact | 3106800560 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
323 N Prairie Ave Suite 200 Inglewood CA 90301-4502 Ph: (310) 680-0560 | 323 N Prairie Ave Suite 200 Inglewood CA 90301-4502 Ph: (310) 680-0560 |
NPI Number | 1306094925 |
---|---|
Provider Enumeration Date | 09/08/2008 |
Last Update Date | 03/05/2009 |
Medicare PECOS PAC ID | 0244396802 |
---|---|
Medicare Enrollment ID | O20090305000448 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306094925 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | A74610 (California) | Primary |
Provider Name | David Kheradyar |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1518917640 PECOS PAC ID: 7618956236 Enrollment ID: I20040716001099 |
Soul Care Licensed Clinical Social Worker Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1316 Centinela Ave, Inglewood, CA 90302 Phone: 424-321-7685 | |
Jikole Helping Hands Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 E Hillcrest Blvd, Inglewood, CA 90301 Phone: 310-292-9941 | |
California Neuromedical Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 301 N Prairie Ave, Ste.315, Inglewood, CA 90301 Phone: 310-680-0304 Fax: 310-680-0305 | |
Maat Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3500 W Manchester Blvd Unit 349, Inglewood, CA 90305 Phone: 323-855-7527 |