Healthcare Provider Details

I. General information

NPI: 1205454204
Provider Name (Legal Business Name): FICUS PSYCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 WILSHIRE BLVD P04 #1188
LOS ANGELES CA
90010-2707
US

IV. Provider business mailing address

3680 WILSHIRE BLVD STE P04 # 1188
LOS ANGELES CA
90010-6101
US

V. Phone/Fax

Practice location:
  • Phone: 929-243-4843
  • Fax:
Mailing address:
  • Phone: 929-243-4843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY SAYER
Title or Position: OWNER
Credential: MD
Phone: 949-584-2202