| Shafa Psychiatric & Consulting Center Apc | |
|
16960 Bastanchury Rd Ste J Yorba Linda CA 92886-1711 | |
| (714) 693-1055 | |
| Not Available |
| Full Name | Shafa Psychiatric & Consulting Center Apc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16960 Bastanchury Rd Ste J, Yorba Linda, California |
| Authorized Official Name and Position | Gohar Khosravi (CEO) |
| Authorized Official Contact | 6573414422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shafa Psychiatric & Consulting Center Apc 1400 N Kraemer Blvd Unit 171 Placentia CA 92871-1408 Ph: (165) 734-1442 | Shafa Psychiatric & Consulting Center Apc 16960 Bastanchury Rd Ste J Yorba Linda CA 92886-1711 Ph: (714) 693-1055 |
| NPI Number | 1376239384 |
|---|---|
| Provider Enumeration Date | 04/12/2023 |
| Last Update Date | 04/14/2023 |
| Medicare PECOS PAC ID | 1557736808 |
|---|---|
| Medicare Enrollment ID | O20230419000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376239384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Gohar Khosravi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912384611 PECOS PAC ID: 2769718436 Enrollment ID: I20190801003436 |
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