| Walter Brown, Ph.d., A Psychological Corporation | |
|
5800 Hannum Ave. Suite 100 Culver City CA 90230-6553 | |
| (310) 410-9504 | |
| (310) 410-9507 |
| Full Name | Walter Brown, Ph.d., A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 5800 Hannum Ave., Culver City, California |
| Authorized Official Name and Position | Walter Brown (PRESIDENT AND OWNER) |
| Authorized Official Contact | 3104109504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walter Brown, Ph.d., A Psychological Corporation 5800 Hannum Ave. Suite 100 Culver City CA 90230-6553 Ph: (310) 410-9504 | Walter Brown, Ph.d., A Psychological Corporation 5800 Hannum Ave. Suite 100 Culver City CA 90230-6553 Ph: (310) 410-9504 |
| NPI Number | 1154646271 |
|---|---|
| Provider Enumeration Date | 03/31/2010 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Medicare PECOS PAC ID | 1658559984 |
|---|---|
| Medicare Enrollment ID | O20110708000483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154646271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY19358 (California) | Primary |
| Provider Name | Walter Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477658680 PECOS PAC ID: 0345276804 Enrollment ID: I20050715000374 |
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