MEDICARE: MENTAL HEALTH CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker
3	106H00000X	Marriage & Family Therapist
4	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
5	163W00000X	Registered Nurse
6	163WI0500X	Infusion Therapy Registered Nurse
7	163WP0808X	Psychiatric/Mental Health Registered Nurse
8	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician
9	2084F0202X	Forensic Psychiatry Physician
10	2084P0804X	Child & Adolescent Psychiatry Physician
11	2084P0805X	Geriatric Psychiatry Physician
12	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
13	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1487255253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	8631 W 3RD ST STE 1100E
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5914
Country	:	US
Telephone Number	:	310-601-9999
Fax Number	:	310-601-9998

Provider Business Practice Location Address
First Line	:	8631 W 3RD ST STE 1100E
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5914
Country	:	US
Telephone Number	:	310-601-9999
Fax Number	:	310-601-9998

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK HRYMOC
Credential	:	MD
Telephone Number	:	310-601-9999

Provider Enumeration Date	:	11/06/2020
Last Update Date	:	01/20/2021

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Directions to “MENTAL HEALTH CENTER ” Practice Location

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