Organization
EAGLEVIEWPSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANVIR PANNU (OWNER)
(916) 999-1418
Entity
Organization
Contact information
Practice address
428 J ST STE 400, SACRAMENTO, CA 95814-2394
(916) 999-1418
(916) 288-8886
Mailing address
8765 HERITAGE HILL DR, ELK GROVE, CA 95624-3945
(916) 999-1418
(916) 288-8886
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/13/2023
Last updated
05/30/2024
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