| Psychedelic Medical Associates Pc | |
|
1247 7th St Ste 300 Santa Monica CA 90401-1644 | |
| (310) 393-7129 | |
| (310) 564-7839 |
| Full Name | Psychedelic Medical Associates Pc |
|---|---|
| Speciality | Internal Medicine - Addiction Medicine |
| Location | 1247 7th St Ste 300, Santa Monica, California |
| Authorized Official Name and Position | Keith Heinzerling (DIRECTOR) |
| Authorized Official Contact | 3103937129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychedelic Medical Associates Pc 1247 7th St Ste 300 Santa Monica CA 90401-1644 Ph: (310) 393-7129 | Psychedelic Medical Associates Pc 1247 7th St Ste 300 Santa Monica CA 90401-1644 Ph: (310) 393-7129 |
| NPI Number | 1588341689 |
|---|---|
| Provider Enumeration Date | 06/29/2023 |
| Last Update Date | 06/29/2023 |
| Certification Date | 06/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588341689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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