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General NPI Number Information
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NPI Number | 1407392319
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Entity Type | Organization
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Legal Business Name | INSTITUTES OF HEALTH BEHAVIORAL MEDICINE AND MEDICAL PSYCHOLOGY INC.
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 2122 S EL CAMINO REAL SUITE 100
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City | OCEANSIDE
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State | CA
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Zip | 92054-6208
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Country | US
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Telephone | 858-405-8238
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Fax |
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Provider Business Mailing Address
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Address Line | 4192 GRAYDON RD
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City | SAN DIEGO
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State | CA
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Zip | 92130-2116
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Country | US
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Telephone | 858-405-8238
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. TOMER ANBAR
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Credential | PH.D. CGC, CTC
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Telephone | 858-405-8238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | A104765
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY15744
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License Number State | CA
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