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General NPI Number Information
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NPI Number | 1437545787
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Entity Type | Organization
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Legal Business Name | AUNGKHIN PSYCHIATRY MEDICAL GROUP INC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 1673 W BROADWAY STE 6
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City | ANAHEIM
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State | CA
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Zip | 92802-1109
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Country | US
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Telephone | 714-774-5915
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Fax | 714-774-8095
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Provider Business Mailing Address
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Address Line | 1673 W BROADWAY STE 6
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City | ANAHEIM
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State | CA
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Zip | 92802-1109
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Country | US
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Telephone | 714-774-5915
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Fax | 714-774-8095
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Authorized Official
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Title or Position | NP
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Name | ANGELA DESAI
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Credential |
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Telephone | 714-774-5915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9871
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 275289
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License Number State | CA
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