Provider Demographics
NPI:1679848022
Name:STUART L ZUBRICK MARRIAGE FAMILY AND CHILD COUNSELING, A PROF CORP
Entity Type:Organization
Organization Name:STUART L ZUBRICK MARRIAGE FAMILY AND CHILD COUNSELING, A PROF CORP
Other - Org Name:INDUSTRIAL HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:P
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-784-3380
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:9041 MAGNOLIA AVE
Practice Address - Street 2:STE 201
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3900
Practice Address - Country:US
Practice Address - Phone:909-784-3380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STUART L ZUBRICK MARRIAGE FAMILY AND CHILD COUNSELING, A PROF CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site