| Mind Space Mental Health Inc | |
|
31852 Coast Hwy Ste 400 Laguna Beach CA 92651-6767 | |
| (949) 689-9754 | |
| Not Available |
| Full Name | Mind Space Mental Health Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 31852 Coast Hwy Ste 400, Laguna Beach, California |
| Authorized Official Name and Position | Charles Tuan-tu Song Nguyen (DOCTOR/CEO) |
| Authorized Official Contact | 9496899754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Space Mental Health Inc 31852 Coast Hwy Ste 400 Laguna Beach CA 92651-6767 Ph: (949) 689-9754 | Mind Space Mental Health Inc 31852 Coast Hwy Ste 400 Laguna Beach CA 92651-6767 Ph: (949) 689-9754 |
| NPI Number | 1720800667 |
|---|---|
| Provider Enumeration Date | 10/31/2024 |
| Last Update Date | 10/31/2024 |
| Medicare PECOS PAC ID | 8527597285 |
|---|---|
| Medicare Enrollment ID | O20250124000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720800667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Charles Tuan-tu S Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942380118 PECOS PAC ID: 4688607906 Enrollment ID: I20050915001194 |
| Provider Name | Hailong Vu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578862256 PECOS PAC ID: 1850600578 Enrollment ID: I20151020003005 |
| Provider Name | Hank H Lai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255750246 PECOS PAC ID: 2163728254 Enrollment ID: I20170411002684 |
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