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Organization
ORANGE PSYCHIATRIC MEDICAL GROUP, INC
Active
Organization
ORANGE PSYCHIATRIC MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAI B CHUNDU M.D. (PRESIDENT/ OWNER)
(951) 737-1917
Entity
Organization
Contact information
Practice address
4000 14TH ST, SUITE 310A, RIVERSIDE, CA 92501-4018
(951) 276-1100
(951) 276-1105
Mailing address
770 MAGNOLIA AVE, SUITE 1F, CORONA, CA 92879-3121
(951) 737-1917
(951) 735-4105
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
103TC0700X
Clinical Psychologist
—
CA
1041C0700X
Clinical Social Worker
—
CA
106H00000X
Marriage & Family Therapist
—
CA
2084P0800X
Psychiatry Physician
Primary
—
CA
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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