Organization · NPI-2

Discovery Practice Management, INC.

Clinic/Center, Adult Mental Health · Los Angeles, CA

NPI number1962077495

StatusActive

Last updated in NPPESMar 26, 2024

Details

NPI: 1962077495
Entity type: Organization (NPI-2)
Legal business name: Discovery Practice Management, INC.
Organization subpart: Yes
Enumeration date: May 26, 2021
Certification date: Mar 26, 2024
Last updated: Mar 26, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM0850X	Clinic/Center, Adult Mental Health	–	–	Yes
320800000X	Community Based Residential Treatment Facility, Mental Illness	–	–
323P00000X	Psychiatric Residential Treatment Facility	–	–

Other names

Discovery Mood & Anxiety Program, Los Angeles (Doing Business As)

Practice location

10780 Santa Monica Blvd Ste 230
Los Angeles, CA 90025-4749

Phone 714-828-1800 · Fax 714-882-1186

Mailing address

18401 Von Karman Ave Ste 500
Irvine, CA 92612-8531

Phone 714-828-1800 · Fax 714-882-1186

Authorized official

Magdalen Gustilo
Director Of Payer Relations
7145687667

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