Provider Demographics
NPI:1043581358
Name:WESTSIDE TMS CENTER
Entity Type:Organization
Organization Name:WESTSIDE TMS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-572-7000
Mailing Address - Street 1:6101 W CENTINELA AVE
Mailing Address - Street 2:SUITE 378
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6337
Mailing Address - Country:US
Mailing Address - Phone:310-258-9524
Mailing Address - Fax:
Practice Address - Street 1:6101 W CENTINELA AVE
Practice Address - Street 2:SUITE 378
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6337
Practice Address - Country:US
Practice Address - Phone:310-258-9524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health