| Pico Outpatient | |
|
1002 Pico Blvd Santa Monica CA 90405-1416 | |
| (310) 314-6200 | |
| (310) 450-2024 |
| Full Name | Pico Outpatient |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1002 Pico Blvd, Santa Monica, California |
| Authorized Official Name and Position | Matt Walton (INTERIM EXECUTIVE OFFICER) |
| Authorized Official Contact | 3103146200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pico Outpatient 909 Pico Blvd Santa Monica CA 90405-1326 Ph: (310) 314-6200 | Pico Outpatient 1002 Pico Blvd Santa Monica CA 90405-1416 Ph: (310) 314-6200 |
| NPI Number | 1063878510 |
|---|---|
| Provider Enumeration Date | 01/13/2016 |
| Last Update Date | 09/20/2024 |
| Certification Date | 09/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063878510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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