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17120 Ridge Park Dr Hacienda Heights CA 91745 | |
| (626) 755-0003 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 17120 Ridge Park Dr, Hacienda Heights, California |
| Authorized Official Name and Position | Benjamin Fredric Corey (OWNER) |
| Authorized Official Contact | 6267550003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
65 Pine Ave # 360 Long Beach CA 90802-4718 Ph: (626) 755-0003 | 17120 Ridge Park Dr Hacienda Heights CA 91745 Ph: (626) 755-0003 |
| NPI Number | 1285038950 |
|---|---|
| Provider Enumeration Date | 10/09/2014 |
| Last Update Date | 03/16/2021 |
| Certification Date | 02/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285038950 | NPI | - | NPPES |
| RW8585 | Other | CA | CCBADC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Sharon Yu Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2440 S Hacienda Blvd Ste 112, Hacienda Heights, CA 91745 Phone: 626-538-7561 | |
Life Focus Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2211 S Hacienda Blvd Ste 103c, Hacienda Heights, CA 91745 Phone: 626-330-7990 Fax: 877-894-5104 | |