| Prototypes | |
|
2555 E Colorado Blvd Ste.100 Pasadena CA 91107-6622 | |
| (626) 577-2261 | |
| (626) 577-2543 |
| Full Name | Prototypes |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2555 E Colorado Blvd, Pasadena, California |
| Authorized Official Name and Position | Doris Doss (MANAGER) |
| Authorized Official Contact | 6265772261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prototypes 2555 E Colorado Blvd Ste.100 Pasadena CA 91107-6622 Ph: (626) 577-2261 | Prototypes 2555 E Colorado Blvd Ste.100 Pasadena CA 91107-6622 Ph: (626) 577-2261 |
| NPI Number | 1336571280 |
|---|---|
| Provider Enumeration Date | 08/02/2013 |
| Last Update Date | 08/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336571280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCS 28715 (California) | Primary |
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