Organization
PRIME HEALTHCARE, INC
Active
Organization
PRIME HEALTHCARE, INC
Active
Other names
PRIME ALLY PROGRAM
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS LEON PH.D., P.A. (CEO)
(619) 470-4115
Entity
Organization
Contact information
Practice address
330 MOSS ST, CHULA VISTA, CA 91911-2005
(619) 472-4586
Mailing address
330 MOSS ST, CHULA VISTA, CA 91911-2005
(619) 472-4586
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
090000086
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37JW
COUNTY OF SAN DIEGO
CA
Enumeration date
05/15/2007
Last updated
08/14/2008
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