| Youth Contact Mulholland Ms | |
|
17120 Vanowen St Lake Balboa CA 91406-4449 | |
| (818) 609-2500 | |
| Not Available |
| Full Name | Youth Contact Mulholland Ms |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 17120 Vanowen St, Lake Balboa, California |
| Authorized Official Name and Position | Timothy Ryder (PRESIDEN) |
| Authorized Official Contact | 8189014830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Contact Mulholland Ms 16360 Roscoe Blvd Fl 2 Van Nuys CA 91406-1219 Ph: (818) 901-4830 | Youth Contact Mulholland Ms 17120 Vanowen St Lake Balboa CA 91406-4449 Ph: (818) 609-2500 |
| NPI Number | 1992209639 |
|---|---|
| Provider Enumeration Date | 03/19/2018 |
| Last Update Date | 03/09/2020 |
| Certification Date | 03/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992209639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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