Healthcare Provider Details
I. General information
NPI: 1194646539
Provider Name (Legal Business Name): CORE MIND INSTITUTE, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1111 N BRAND BLVD STE 312
GLENDALE CA
91202-3071
US
IV. Provider business mailing address
1111 N BRAND BLVD STE 312
GLENDALE CA
91202-3071
US
V. Phone/Fax
- Phone: 323-230-0017
- Fax: 323-381-5984
- Phone: 323-230-0017
- Fax: 323-381-5984
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRISTIAN
PENCIU
Title or Position: OWNER
Credential: MD
Phone: 323-896-6647