Organization
MIND & BODY TREATMENT AND RESEARCH INSTITUTE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJAGOPAL KEERTHY SUNDER M.D. (OWNER)
(510) 685-2022
Entity
Organization
Contact information
Practice address
5700 DIVISION ST, 200, RIVERSIDE, CA 92506-3257
(951) 300-4905
Mailing address
3060 EL CERRITO PLZ, SUITE 266, EL CERRITO, CA 94530-4011
(510) 685-2022
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
A94223
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101426267 0001
—
PA
Enumeration date
08/16/2014
Last updated
02/17/2016
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