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MIND & BODY TREATMENT AND RESEARCH INSTITUTE PC NPI 1740689694


NPI Information

NPI: 1740689694
Provider Name: MIND & BODY TREATMENT AND RESEARCH INSTITUTE, PC
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
5700 DIVISION ST
200
RIVERSIDE, CA
ZIP 92506
Phone: (951) 300-4905
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MIND & BODY TREATMENT AND RESEARCH INSTITUTE, PC is an addiction medicine psychiatry neurology in Riverside, CA. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine MIND & BODY TREATMENT AND RESEARCH INSTITUTE, PC NPI is 1740689694. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5700 DIVISION ST
200
RIVERSIDE, CA
ZIP 92506-257
Phone: (951) 300-4905

The provider's authorized official is Rajagopal Keerthy Sunder .
The authorized official title is Owner and has the following contact phone number (510) 685-2022.

The enumeration date for this NPI number is 8/16/2014 and was last updated on 2/17/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084A0401XPsychiatry & NeurologyAddiction MedicineA94223CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1I44936MEDICARE UPINPENNSYLVANIA
2101426267 0001MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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