Provider Demographics
NPI:1376696476
Name:PASADENA PSYCHIATRIC MEDICAL GROUP
Entity Type:Organization
Organization Name:PASADENA PSYCHIATRIC MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-795-9174
Mailing Address - Street 1:301 E COLORADO BLVD STE 628
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1918
Mailing Address - Country:US
Mailing Address - Phone:626-795-9174
Mailing Address - Fax:
Practice Address - Street 1:301 E COLORADO BLVD STE 628
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1918
Practice Address - Country:US
Practice Address - Phone:626-795-9174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty