Provider Demographics
NPI:1710279070
Name:CLEAR INSIGHT PSYCHIATRY, INC
Entity Type:Organization
Organization Name:CLEAR INSIGHT PSYCHIATRY, INC
Other - Org Name:DR. LIANG'S MEDICAL OFFICE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-354-1304
Mailing Address - Street 1:15561 VIA LA VENTANA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-4316
Mailing Address - Country:US
Mailing Address - Phone:858-354-1304
Mailing Address - Fax:858-566-4120
Practice Address - Street 1:9750 MIRAMAR RD
Practice Address - Street 2:SUITE 315
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4560
Practice Address - Country:US
Practice Address - Phone:858-354-1304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96420261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEW977AMedicare PIN