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Organization
PSYCHEDELIC MEDICAL ASSOCIATES PC
Active
Organization
PSYCHEDELIC MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH HEINZERLING MD (DIRECTOR)
(310) 393-7129
Entity
Organization
Contact information
Practice address
1247 7TH ST STE 300, SANTA MONICA, CA 90401-1644
(310) 393-7129
(310) 564-7839
Mailing address
1247 7TH ST STE 300, SANTA MONICA, CA 90401-1644
(310) 393-7129
(310) 564-7839
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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