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NPI Code Detail

MEDICARE: DISCOVERY PRACTICE MANAGEMENT, INC.

MEDICARE: DISCOVERY PRACTICE MANAGEMENT, INC.
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
1323P00000XPsychiatric Residential Treatment Facility
2320800000XMental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1932726346
Entity Type Code : Organization
Provider Name (Legal Business Name) : DISCOVERY PRACTICE MANAGEMENT, INC.
Provider Business Mailing Address
First Line : 18401 VON KARMAN AVE STE 500
Second Line :
City : IRVINE
State : CA
Zip : 92612-8531
Country : US
Telephone Number : 714-828-1800
Fax Number : 714-882-1186
Provider Business Practice Location Address
First Line : 2009 SAINT STEPHENS WOODS DR
Second Line :
City : CROWNSVILLE
State : MD
Zip : 21032-2200
Country : US
Telephone Number : 714-828-1800
Fax Number : 714-882-1186
Authorized Official
Title or Position : DIRECTOR OF PAYER RELATIONS
Name : MAGDALEN GUSTILO
Credential :
Telephone Number : 714-568-7667
Provider Enumeration Date : 07/01/2020
Last Update Date : 11/02/2023

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