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NPI Code Detail

MEDICARE: WEST COAST PSYCHIATRY MD P.C.

MEDICARE: WEST COAST PSYCHIATRY MD P.C.
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1477352581
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST COAST PSYCHIATRY MD P.C.
Provider Business Mailing Address
First Line : 23110 ATLANTIC CIR
Second Line :
City : MORENO VALLEY
State : CA
Zip : 92553-5920
Country : US
Telephone Number : 248-877-5452
Fax Number :
Provider Business Practice Location Address
First Line : 200 FREEDOM LN
Second Line :
City : ALISO VIEJO
State : CA
Zip : 92656-5876
Country : US
Telephone Number : 248-877-5452
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ABRAHAM MAAZ
Credential : MD
Telephone Number : 248-877-5452
Provider Enumeration Date : 03/11/2025
Last Update Date : 03/11/2025

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