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General NPI Number Information
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NPI Number | 1790156271
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Entity Type | Organization
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Legal Business Name | CAMDEN PHYSICIANS GROU, INC.
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 10780 SANTA MONICA BLVD SUITE 105
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City | LOS ANGELES
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State | CA
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Zip | 90025-4749
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Country | US
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Telephone | 844-422-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 10780 SANTA MONICA BLVD SUITE 105
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City | LOS ANGELES
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State | CA
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Zip | 90025-4749
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Country | US
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Telephone | 844-422-6336
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MISS JESSICA KLEIN
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Credential |
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Telephone | 844-422-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY25565
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY19135
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS59977
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC48114
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | AC11797
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC11797
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A112538
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | A100456
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05D2068012
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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