Provider Demographics
NPI:1578907937
Name:PARAGON PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:PARAGON PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:424-257-0123
Mailing Address - Street 1:3727 W 6TH ST
Mailing Address - Street 2:SUITE 507
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5105
Mailing Address - Country:US
Mailing Address - Phone:424-257-0123
Mailing Address - Fax:
Practice Address - Street 1:3727 W 6TH ST
Practice Address - Street 2:SUITE 507
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5105
Practice Address - Country:US
Practice Address - Phone:424-257-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24390251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health