| Western Specialty Group L.p. | |
|
7850 Vista Hill Ave San Diego CA 92123-2717 | |
| (858) 836-8434 | |
| Not Available |
| Full Name | Western Specialty Group L.p. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7850 Vista Hill Ave, San Diego, California |
| Authorized Official Name and Position | Brian Miller (PARTNER) |
| Authorized Official Contact | 8584422434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Specialty Group L.p. Po Box 516527 Los Angeles CA 90051-0590 Ph: (858) 836-8434 | Western Specialty Group L.p. 7850 Vista Hill Ave San Diego CA 92123-2717 Ph: (858) 836-8434 |
| NPI Number | 1528770385 |
|---|---|
| Provider Enumeration Date | 12/22/2022 |
| Last Update Date | 10/18/2023 |
| Certification Date | 10/18/2023 |
| Medicare PECOS PAC ID | 9739544859 |
|---|---|
| Medicare Enrollment ID | O20230425001314 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528770385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Elizabeth R Hudler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134287352 PECOS PAC ID: 0446231732 Enrollment ID: I20040524001446 |
| Provider Name | Brian P Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861411381 PECOS PAC ID: 1658441480 Enrollment ID: I20080604000748 |
| Provider Name | David Lindley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902275068 PECOS PAC ID: 6103243316 Enrollment ID: I20200902003144 |
| Provider Name | Justin M Cantley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568062552 PECOS PAC ID: 9133531528 Enrollment ID: I20201208002558 |
| Provider Name | Noorsaba Bahramzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992270698 PECOS PAC ID: 5092102426 Enrollment ID: I20220503001420 |
| Provider Name | Massooda Paband |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417619818 PECOS PAC ID: 9133596950 Enrollment ID: I20221108003115 |
| Provider Name | Reem Sadda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871921833 PECOS PAC ID: 9931467628 Enrollment ID: I20230425001840 |
| Provider Name | Lauren Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407639818 PECOS PAC ID: 6709232952 Enrollment ID: I20231025001147 |
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