Organization
CLIFFSIDE MALIBU II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDALEN GUSTILO (DIRECTOR OF PAYER RELATIONS)
(714) 568-7667
Entity
Organization
Contact information
Practice address
5853 BUSCH DRIVE, MALIBU, CA 90265
(424) 781-4723
Mailing address
18401 VON KARMAN AVE STE 500, IRVINE, CA 92612-8531
(714) 828-1800
(714) 882-1186
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190073AP
CA
324500000X
Substance Abuse Rehabilitation Facility
190658AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190658AP
ADP LICENSE
CA
Enumeration date
10/20/2010
Last updated
01/02/2024
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