| |
13400 Erwin St Van Nuys CA 91401-3014 | |
(818) 988-6292 | |
Not Available |
Full Name | |
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Speciality | Psychiatry & Neurology - Psychiatry |
Location | 13400 Erwin St, Van Nuys, California |
Authorized Official Name and Position | Timothy Ryder (PRESIDENT) |
Authorized Official Contact | 8189014830 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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16360 Roscoe Blvd Fl 2 Van Nuys CA 91406-1219 Ph: (818) 901-4830 | 13400 Erwin St Van Nuys CA 91401-3014 Ph: (818) 988-6292 |
NPI Number | 1053815795 |
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Provider Enumeration Date | 03/19/2018 |
Last Update Date | 03/09/2020 |
Certification Date | 03/09/2020 |
Identifier | Type | State | Issuer |
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1053815795 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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