Organization
TAKESHIA C. NIDAY, M.D. A PROFESSIONAL CORPORATION
Active
Organization
TAKESHIA C. NIDAY, M.D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAKESHIA NIDAY M.D. (PRESIDENT)
(619) 500-6566
Entity
Organization
Contact information
Practice address
2760 FIFTH AVE, SUITE 205, SAN DIEGO, CA 92103-6325
(619) 500-6566
(619) 374-2982
Mailing address
2760 FIFTH AVE, SUITE 205, SAN DIEGO, CA 92103-6325
(619) 500-6566
(619) 374-2982
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
A113548
CA
283Q00000X
Psychiatric Hospital
Primary
A113548
CA
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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