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Organization
PHYSICIAN HEALTH COLLABORATIVE CORPORATION
Active
Organization
PHYSICIAN HEALTH COLLABORATIVE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART LEVINE MD (SOLE SHAREHOLDER)
(760) 955-9555
Entity
Organization
Contact information
Practice address
11497 BARTLETT AVE STE B1, ADELANTO, CA 92301-1901
(760) 246-6600
(760) 955-8558
Mailing address
11497 BARTLETT AVE STE B1, ADELANTO, CA 92301-1901
(760) 246-6600
(760) 955-8558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A87666
CA
2084P0800X
Psychiatry Physician
G57910
CA
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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