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General NPI Number Information
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NPI Number | 1437646296
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Entity Type | Organization
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Legal Business Name | CONF PSYCHIATRIC SERVICES INC
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 655 CANYON RD
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City | NOVATO
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State | CA
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Zip | 94947-4331
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Country | US
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Telephone | 415-892-1628
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Fax |
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Provider Business Mailing Address
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Address Line | 820 RANDOLPH ST # 6952
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City | NAPA
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State | CA
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Zip | 94559-9894
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NEIL KHANNA
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Credential | MD
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Telephone | 310-896-6267
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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 | C54836
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License Number State | CA
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