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Organization
WELL PSYCHE MEDICAL GROUP
Active
Organization
WELL PSYCHE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEL MOSTAFAVI MD (CEO)
(949) 400-2488
Entity
Organization
Contact information
Practice address
15260 VENTURA BLVD STE 1200, SHERMAN OAKS, CA 91403-5347
(310) 871-0670
(310) 469-7845
Mailing address
15260 VENTURA BLVD STE 1200, SHERMAN OAKS, CA 91403-5347
(310) 871-0670
(310) 469-7845
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
A92472
CA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A92472
CA
2084P0804X
Child & Adolescent Psychiatry Physician
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
01/10/2013
Last updated
06/21/2024
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