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General NPI Number Information
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NPI Number | 1215075460
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Entity Type | Organization
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Legal Business Name | ADVANCED PSYCHIATRIC MEDICINE, P.C.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 29240 BUCKINGHAM ST SUITE 8A
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City | LIVONIA
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State | MI
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Zip | 48154-4575
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Country | US
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Telephone | 248-299-4211
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Fax | 248-299-2392
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Provider Business Mailing Address
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Address Line | 29240 BUCKINGHAM ST SUITE 8A
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City | LIVONIA
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State | MI
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Zip | 48154-4575
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Country | US
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Telephone | 248-299-4211
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Fax | 248-299-2392
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORGE S ZUNIGA
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Credential | M.D.
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Telephone | 248-299-4211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 033694
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License Number State | MI
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