Provider Demographics
NPI:1588041818
Name:STUART L. ZUBRICK, MARRIAGE, FAMILY AND CHILD COUNSELING, A PROFESSION
Entity type:Organization
Organization Name:STUART L. ZUBRICK, MARRIAGE, FAMILY AND CHILD COUNSELING, A PROFESSION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-6681
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-943-4180
Mailing Address - Fax:888-431-8819
Practice Address - Street 1:40485 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:SUITE B7
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6436
Practice Address - Country:US
Practice Address - Phone:213-484-6681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STUART L. ZUBRICK, MARRIAGE, FAMILY AND CHILD COUNSELING, A PROFESSION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74233332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site