Provider Demographics
NPI:1023188588
Name:RESOURCE SHARING PSYCHIATRIC MEDICAL GROUP
Entity Type:Organization
Organization Name:RESOURCE SHARING PSYCHIATRIC MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHENVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-514-5126
Mailing Address - Street 1:8787 COMPLEX DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1419
Mailing Address - Country:US
Mailing Address - Phone:858-514-5126
Mailing Address - Fax:858-514-5191
Practice Address - Street 1:8787 COMPLEX DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1419
Practice Address - Country:US
Practice Address - Phone:858-514-5126
Practice Address - Fax:858-514-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG392892084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty