| Physician Health Collaborative Corporation | |
|
11497 Bartlett Ave Ste B1 Adelanto CA 92301-1901 | |
| (760) 246-6600 | |
| (760) 955-8558 |
| Full Name | Physician Health Collaborative Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 11497 Bartlett Ave Ste B1, Adelanto, California |
| Authorized Official Name and Position | Stuart Levine (SOLE SHAREHOLDER) |
| Authorized Official Contact | 7609559555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Health Collaborative Corporation 11497 Bartlett Ave Ste B1 Adelanto CA 92301-1901 Ph: (760) 246-6600 | Physician Health Collaborative Corporation 11497 Bartlett Ave Ste B1 Adelanto CA 92301-1901 Ph: (760) 246-6600 |
| NPI Number | 1851821680 |
|---|---|
| Provider Enumeration Date | 06/14/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851821680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A87666 (California) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G57910 (California) | Secondary |
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