Organization
A PSYCHOLOGICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE NEIL BLUM PHD (CORPORATION PRESIDENT)
(562) 493-4655
Entity
Organization
Contact information
Practice address
5188 KATELLA AVE, STE 205, LOS ALAMITOS, CA 90720
(562) 493-4655
(562) 493-8897
Mailing address
5188 KATELLA AVE, STE 205, LOS ALAMITOS, CA 90720
(562) 493-4655
(562) 493-8897
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY6896
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PL68960
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/04/2006
Last updated
06/16/2008
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