Provider Demographics
NPI:1407809650
Name:CALIFORNIA PSYCHIATRIC MEDICAL GROUP
Entity Type:Organization
Organization Name:CALIFORNIA PSYCHIATRIC MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-934-0800
Mailing Address - Street 1:3478 BUSKIRK AVE
Mailing Address - Street 2:SUITE 219
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4346
Mailing Address - Country:US
Mailing Address - Phone:925-934-0800
Mailing Address - Fax:925-952-4032
Practice Address - Street 1:3478 BUSKIRK AVE,
Practice Address - Street 2:SUITE 219
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4346
Practice Address - Country:US
Practice Address - Phone:925-934-0800
Practice Address - Fax:925-952-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty