Organization
CHAGRIN VALLEY PSYCHIATRIC ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD JACOB GATES D.O. (PRESIDENT)
(440) 227-3691
Entity
Organization
Contact information
Practice address
7500 THATCHUM LN, MENTOR, OH 44060-6814
(440) 227-3691
(863) 438-6126
Mailing address
7500 THATCHUM LN, MENTOR, OH 44060-6814
(440) 227-3691
(863) 438-6126
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34004091
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH92497315
MEDICARE GROUP PIN
OH
Enumeration date
03/04/2008
Last updated
02/27/2012
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