| The Open Table | |
|
151 Kalmus Dr. Bldg C Suite 100 Costa Mesa CA 92626 | |
| (949) 274-9627 | |
| Not Available |
| Full Name | The Open Table |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 151 Kalmus Dr. Bldg C, Costa Mesa, California |
| Authorized Official Name and Position | Matthew Heim (DIRECTOR) |
| Authorized Official Contact | 9492749627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Open Table 1633 E 4th St Ste 120 Santa Ana CA 92701-5143 Ph: (949) 274-9627 | The Open Table 151 Kalmus Dr. Bldg C Suite 100 Costa Mesa CA 92626 Ph: (949) 274-9627 |
| NPI Number | 1396383022 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 12/12/2019 |
| Certification Date | 12/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396383022 | NPI | - | NPPES |
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