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23700 Camino Del Sol Torrance CA 90505-5017 | |
| (310) 714-3836 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 23700 Camino Del Sol, Torrance, California |
| Authorized Official Name and Position | Valentina Park (OWNER) |
| Authorized Official Contact | 3107143836 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2748 Pacific Coast Hwy # 1084 Torrance CA 90505-7002 Ph: () - | 23700 Camino Del Sol Torrance CA 90505-5017 Ph: (310) 714-3836 |
| NPI Number | 1699504282 |
|---|---|
| Provider Enumeration Date | 07/31/2024 |
| Last Update Date | 08/09/2024 |
| Certification Date | 08/09/2024 |
| Medicare PECOS PAC ID | 5991237174 |
|---|---|
| Medicare Enrollment ID | O20241011003827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699504282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Valentina Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023579513 PECOS PAC ID: 3274974118 Enrollment ID: I20240509002922 |
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