Organization
DEEP WATERS PSYCHIATRIC MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN ANNELLE MAURER (CORPORATE SECRETARY)
(888) 984-7888
Entity
Organization
Contact information
Practice address
9531 PITTSBURGH AVE, RANCHO CUCAMONGA, CA 91730-6008
(909) 256-8360
Mailing address
PO BOX 11387, SAN BERNARDINO, CA 92423-1387
(888) 984-7888
(888) 984-7888
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
CA
Other
Enumeration date
03/18/2017
Last updated
03/18/2017
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