Provider Demographics
NPI:1629216031
Name:DR. NAGAR MEDICAL PSYCHOLOGY CENTER INC
Entity Type:Organization
Organization Name:DR. NAGAR MEDICAL PSYCHOLOGY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIVA
Authorized Official - Middle Name:B
Authorized Official - Last Name:NAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-361-7717
Mailing Address - Street 1:PO BOX 7729
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91327-7729
Mailing Address - Country:US
Mailing Address - Phone:818-361-7717
Mailing Address - Fax:818-831-7090
Practice Address - Street 1:14901 RINALDI ST STE 335
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1237
Practice Address - Country:US
Practice Address - Phone:818-361-7717
Practice Address - Fax:818-831-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13502103T00000X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1114933074OtherNPI
CACP13502BOtherMEDICARE PTAN
CAPSY13502OtherLICENSE