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Organization
PORTER RANCH PSYCHIATRIC MEDICAL CORPORATION
Active
Organization
PORTER RANCH PSYCHIATRIC MEDICAL CORPORATION
Active
Parent organization
PORTER RANCH PSYCHIATRIC MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PORTER RANCH PSYCHIATRIC MEDICAL CORPORATION
Authorized official
RAJ KAMAT (BILLER)
(818) 527-1288
Entity
Organization
Contact information
Practice address
18250 ROSCOE BLVD STE 245, NORTHRIDGE, CA 91325-4248
(818) 527-1288
(818) 812-9025
Mailing address
PO BOX 7008, NORTHRIDGE, CA 91327-7008
(818) 527-1288
(818) 428-3237
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A322501
—
CA
Enumeration date
11/15/2007
Last updated
01/12/2015
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