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General NPI Number Information
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NPI Number | 1578000584
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Entity Type | Organization
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Legal Business Name | MINDCARE PARTNERS, INC.
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Dates
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Enumeration Date | 01/28/2017
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Last Update Date | 01/28/2017
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Provider Practice Location Address
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Address Line | 10650 REAGAN ST UNIT 232
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-8800
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Country | US
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Telephone | 562-833-0496
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Fax |
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Provider Business Mailing Address
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Address Line | 10650 REAGAN ST UNIT 232
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-8800
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Country | US
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Telephone | 562-833-0496
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JOSEPH GUADUAPE MARQUEZ
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Credential | D.O.
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Telephone | 562-833-0496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 20A 8470
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License Number State | CA
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