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General NPI Number Information
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NPI Number | 1881468502
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Entity Type | Organization
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Legal Business Name | UNIVERSAL PSYCHIATRY AND ADDICTION CARE SERVICES
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 15523 COLLINA STRADA
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City | LOS ANGELES
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State | CA
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Zip | 90077-1513
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Country | US
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Telephone | 747-249-4383
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Fax |
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Provider Business Mailing Address
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Address Line | 905 DICKSON ST
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5512
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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 | SECRETARY
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Name | LEA HUMMEL
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Credential |
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Telephone | 747-888-7911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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