Provider Demographics
NPI:1831270289
Name:COMPREHENSIVE DOCTORS MEDICAL GROUP INC.
Entity type:Organization
Organization Name:COMPREHENSIVE DOCTORS MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-462-5810
Mailing Address - Street 1:150 N. SANTA ANITA AVE
Mailing Address - Street 2:#735
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006
Mailing Address - Country:US
Mailing Address - Phone:626-462-5810
Mailing Address - Fax:626-446-9686
Practice Address - Street 1:150 N. SANTA ANITA AVE
Practice Address - Street 2:#735
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006
Practice Address - Country:US
Practice Address - Phone:626-462-5810
Practice Address - Fax:626-446-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4152103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty