Organization
VIRTUOSO PSYCHIATRY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHACHARAWUT J KANCHANANAKHIN MD (PRESIDENT)
(530) 902-7875
Entity
Organization
Contact information
Practice address
5040 WOODSPRING CT, GRANITE BAY, CA 95746-8838
(530) 902-7875
(916) 784-2610
Mailing address
5040 WOODSPRING CT, GRANITE BAY, CA 95746-8838
(530) 902-7875
(916) 784-2610
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
A91530
CA
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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