| Alta Behavioral And Wellness Medical Group Inc. | |
|
2410 S Azusa Avenue West Covina CA 91792-1512 | |
| (909) 282-0794 | |
| Not Available |
| Full Name | Alta Behavioral And Wellness Medical Group Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2410 S Azusa Avenue, West Covina, California |
| Authorized Official Name and Position | Marlon H. Carpio (NURSE PRACTITIONER) |
| Authorized Official Contact | 9092820794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta Behavioral And Wellness Medical Group Inc. 2410 S Azusa Avenue West Covina CA 91792-1512 Ph: (909) 282-0794 | Alta Behavioral And Wellness Medical Group Inc. 2410 S Azusa Avenue West Covina CA 91792-1512 Ph: (909) 282-0794 |
| NPI Number | 1730981184 |
|---|---|
| Provider Enumeration Date | 03/26/2025 |
| Last Update Date | 03/26/2025 |
| Certification Date | 03/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730981184 | NPI | - | NPPES |
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