Provider Demographics
NPI:1295847234
Name:PSYCHIATRIC ASSOCIATES NORTH COUNTY MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES NORTH COUNTY MEDICAL GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-743-1205
Mailing Address - Street 1:125 S GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4406
Mailing Address - Country:US
Mailing Address - Phone:760-743-1205
Mailing Address - Fax:
Practice Address - Street 1:125 S GRAPE ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4406
Practice Address - Country:US
Practice Address - Phone:760-743-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB55532Medicare UPIN
CAA90668Medicare UPIN
CAA90394Medicare UPIN
W1893Medicare PIN
CAA62279Medicare UPIN