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NPI Code Detail

MEDICARE: COMPASSIONATE RECOVERY ASSOCIATES

MEDICARE: COMPASSIONATE RECOVERY ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2261QP3300XPain Clinic/Center
32084A0401XAddiction Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number : 1083505861
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPASSIONATE RECOVERY ASSOCIATES
Provider Business Mailing Address
First Line : 2023 KENDRA CT
Second Line :
City : LOS ANGELES
State : CA
Zip : 90068-3846
Country : US
Telephone Number : 310-266-3774
Fax Number : 323-380-7420
Provider Business Practice Location Address
First Line : 2023 KENDRA CT STE 102
Second Line :
City : LOS ANGELES
State : CA
Zip : 90068-3846
Country : US
Telephone Number : 310-266-3774
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. RYAN PETERSON
Credential : MD
Telephone Number : 310-266-3774
Provider Enumeration Date : 07/10/2025
Last Update Date : 12/26/2025

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