Provider Demographics
NPI:1609367598
Name:MICHAEL MCGINTY PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL MCGINTY PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:MURPHY
Authorized Official - Last Name:MCGINTY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:858-900-5848
Mailing Address - Street 1:8950 VILLA LA JOLLA DR STE B204
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1705
Mailing Address - Country:US
Mailing Address - Phone:858-900-5848
Mailing Address - Fax:
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE B204
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1705
Practice Address - Country:US
Practice Address - Phone:858-900-5848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB2017013070261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)