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NPI Code Detail

MEDICARE: PSYCHIATRIC HEALTHCARE MEDICAL CORP

MEDICARE: PSYCHIATRIC HEALTHCARE MEDICAL CORP
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
1273R00000XPsychiatric Hospital UnitG65182CA

General Provider Information

NPI Number : 1730235235
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHIATRIC HEALTHCARE MEDICAL CORP
Provider Business Mailing Address
First Line : 3569 SACRAMENTO ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-1866
Country : US
Telephone Number : 415-522-9297
Fax Number : 415-771-4048
Provider Business Practice Location Address
First Line : 3569 SACRAMENTO ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-1866
Country : US
Telephone Number : 415-522-9297
Fax Number : 415-771-4048
Authorized Official
Title or Position : CEO
Name : CHARLES P. CONNOR
Credential : MD
Telephone Number : 415-522-9297
Provider Enumeration Date : 01/26/2007
Last Update Date : 06/10/2011

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1245482306 — MS. BETH AUMAN BRILL M.F.T.
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