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Organization
OAK LEAF PSYCHIATRY INC
Active
Organization
OAK LEAF PSYCHIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGARDO JORGE MENVIELLE MD (OWNER)
(626) 569-8074
Entity
Organization
Contact information
Practice address
200 E DEL MAR BLVD, PASADENA, CA 91105-2544
(626) 569-8074
Mailing address
200 E DEL MAR BLVD, PASADENA, CA 91105-2544
(626) 569-8074
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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