Healthcare Provider Details

I. General information

NPI: 1992384036
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHIATRIC SOLUTIONS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11878 AVENUE OF INDUSTRY
SAN DIEGO CA
92128-3423
US

IV. Provider business mailing address

1450 W LONG LAKE RD STE 340
TROY MI
48098-6330
US

V. Phone/Fax

Practice location:
  • Phone: 858-487-3200
  • Fax:
Mailing address:
  • Phone: 248-905-5091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: HANA ATTAR
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 248-905-5091