Organization
BRISAS IOP, LLC
Active
Other names
BRISAS IOP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJAGOPAL KEERTHY SUNDER M.D., (PROGRAM DIRECTOR)
(510) 685-2022
Entity
Organization
Contact information
Practice address
5700 DIVISION ST, STE 200, RIVERSIDE, CA 92506-3257
(510) 685-2022
Mailing address
3060 EL CERRITO PLZ, STE 266, EL CERRITO, CA 94530-4011
(510) 685-2022
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
A942233
CA
Other
Enumeration date
11/17/2014
Last updated
02/17/2016
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