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General NPI Number Information
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NPI Number | 1932891199
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Entity Type | Organization
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Legal Business Name | BIXBY MENTAL HEALTH INC.
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 600 S SAN VICENTE BLVD STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90048-4664
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Country | US
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Telephone | 310-873-3312
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Fax |
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Provider Business Mailing Address
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Address Line | 9663 SANTA MONICA BLVD STE 883
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 310-873-3312
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DANIEL LING
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Credential | MD
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Telephone | 310-956-1123
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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