Provider Demographics
NPI:1265253504
Name:CENTERED MEDICINE, PC
Entity type:Organization
Organization Name:CENTERED MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOONIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-294-4119
Mailing Address - Street 1:PO BOX 270875
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92198-2875
Mailing Address - Country:US
Mailing Address - Phone:858-375-6670
Mailing Address - Fax:
Practice Address - Street 1:7850 VISTA HILL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2717
Practice Address - Country:US
Practice Address - Phone:858-836-8434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty