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Organization
SAN DIEGO MENTAL HEALTH ASSOCIATES MEDICAL CLINIC INC.
Active
Organization
SAN DIEGO MENTAL HEALTH ASSOCIATES MEDICAL CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLENISE C TRAPP (OFFICE MANAGER)
(619) 291-4808
Entity
Organization
Contact information
Practice address
3914 THIRD AVENUE, SAN DIEGO, CA 92103-3094
(619) 291-4808
(619) 291-4426
Mailing address
3914 THIRD AVENUE, SAN DIEGO, CA 92103-3094
(619) 291-4808
(619) 291-4426
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C25697
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ72044Z
—
CA
Enumeration date
06/20/2007
Last updated
03/23/2016
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