Healthcare Provider Details

I. General information

NPI: 1023188588
Provider Name (Legal Business Name): RESOURCE SHARING PSYCHIATRIC MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 COMPLEX DR SUITE 200
SAN DIEGO CA
92123-1419
US

IV. Provider business mailing address

8787 COMPLEX DR SUITE 200
SAN DIEGO CA
92123-1419
US

V. Phone/Fax

Practice location:
  • Phone: 858-514-5126
  • Fax: 858-514-5191
Mailing address:
  • Phone: 858-514-5126
  • Fax: 858-514-5191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG39289
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG39289
License Number StateCA

VIII. Authorized Official

Name: DR. MARK S CHENVEN
Title or Position: PRESIDENT & CEO
Credential: M.D.
Phone: 858-514-5126