| |
1360 W 6th St Ste 205&115 San Pedro CA 90732-3567 | |
(310) 833-3135 | |
(310) 833-3572 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 1360 W 6th St Ste 205&115, San Pedro, California |
Authorized Official Name and Position | Maria Amador (ECRS MANAGER) |
Authorized Official Contact | 5624853028 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1301 Pine Ave Long Beach CA 90813-3124 Ph: (562) 595-1159 | 1360 W 6th St Ste 205&115 San Pedro CA 90732-3567 Ph: (310) 833-3135 |
NPI Number | 1174654156 |
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Provider Enumeration Date | 03/08/2007 |
Last Update Date | 02/07/2025 |
Certification Date | 02/07/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174654156 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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