| Palos Verdes | |
|
1290 Commodore Dr San Bruno CA 94066-2304 | |
| (650) 583-1260 | |
| Not Available |
| Full Name | Palos Verdes |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1290 Commodore Dr, San Bruno, California |
| Authorized Official Name and Position | Scott Gilman (MENTAL HEALTH DIRECTOR) |
| Authorized Official Contact | 6505732748 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palos Verdes 1290 Commodore Dr San Bruno CA 94066-2304 Ph: (650) 583-1260 | Palos Verdes 1290 Commodore Dr San Bruno CA 94066-2304 Ph: (650) 583-1260 |
| NPI Number | 1093807315 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/26/2022 |
| Certification Date | 08/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093807315 | NPI | - | NPPES |
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