Organization
AEGIS TREATMENT CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAIPHONG THANH VO (CREDENTIALING SUPERVISOR)
(818) 206-0360
Entity
Organization
Contact information
Practice address
11041 VALLEY BLVD, EL MONTE, CA 91731-2516
(626) 442-4177
Mailing address
7246 REMMET AVE, CANOGA PARK, CA 91303-1531
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HDC70071F
—
CA
Enumeration date
05/20/2013
Last updated
03/08/2023
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