| Prime Healthcare Paradise Valley Llc | |
|
2400 E 4th St National City CA 91950-2026 | |
| (619) 470-4321 | |
| (619) 470-4103 |
| Full Name | Prime Healthcare Paradise Valley Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2400 E 4th St, National City, California |
| Authorized Official Name and Position | Christopher Doan (MANAGING ASSOCIATE GENERAL COUNSEL) |
| Authorized Official Contact | 3102594706 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Healthcare Paradise Valley Llc 2400 E 4th St National City CA 91950-2026 Ph: (619) 470-4124 | Prime Healthcare Paradise Valley Llc 2400 E 4th St National City CA 91950-2026 Ph: (619) 470-4321 |
| NPI Number | 1285064907 |
|---|---|
| Provider Enumeration Date | 11/15/2013 |
| Last Update Date | 12/10/2020 |
| Certification Date | 12/10/2020 |
| Medicare PECOS PAC ID | 4587664412 |
|---|---|
| Medicare Enrollment ID | O20140417001126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285064907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 090000086 (California) | Primary |
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