Organization
INTERNATIONAL CENTER FOR BEHAVIORAL HEALTH
Active
Organization
INTERNATIONAL CENTER FOR BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRIY SIVTSOV (DIRECTOR)
(858) 729-4770
Entity
Organization
Contact information
Practice address
3252 HOLIDAY CT, STE 108, LA JOLLA, CA 92037-0027
(858) 729-4668
Mailing address
4146 CAMINITO CASSIS, SAN DIEGO, CA 92122-1975
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A88348
CA
Other
Enumeration date
04/18/2010
Last updated
04/18/2010
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