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General NPI Number Information
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NPI Number | 1134933385
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Entity Type | Organization
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Legal Business Name | MDLEY CO
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 806 AVENIDA PICO
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-5639
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Country | US
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Telephone | 775-550-7401
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Fax |
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Provider Business Mailing Address
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Address Line | 806 AVENIDA PICO
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-5639
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Country | US
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Telephone | 775-550-7401
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DEEPAK RAJPOOT
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Credential | MD
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Telephone | 775-550-7401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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