Organization
ADDICTION SPECIALIST OF SOUTHERN CALIFORNIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE VERNON TUCKER M.D. (OWNER)
(949) 390-4730
Entity
Organization
Contact information
Practice address
4000 MACARTHUR BLVD, SUITE 600 EAST TOWER, NEWPORT BEACH, CA 92660-2517
(949) 390-4730
(949) 627-8107
Mailing address
66 ENGLISH SADDLE, IRVINE, CA 92602-1839
(949) 390-4730
(949) 627-8107
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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