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NPI Code Detail

MEDICARE: DIDI HIRSCH PSYCHIATRIC SERVICE

MEDICARE: DIDI HIRSCH PSYCHIATRIC SERVICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1295866283
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIDI HIRSCH PSYCHIATRIC SERVICE
Provider Business Mailing Address
First Line : 4760 SEPULVEDA BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4820
Country : US
Telephone Number : 310-390-6612
Fax Number : 310-398-5690
Provider Business Practice Location Address
First Line : 221 N ARDMORE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-4503
Country : US
Telephone Number : 213-381-3626
Fax Number : 213-380-8923
Authorized Official
Title or Position : CONTRACTS & GRANTS MANAGER
Name : DULCE M RUIZ
Credential :
Telephone Number : 310-751-5442
Provider Enumeration Date : 03/08/2007
Last Update Date : 09/27/2022

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Directions to “DIDI HIRSCH PSYCHIATRIC SERVICE ” Practice Location

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