PITUCK MEDICAL GROUP, INC.

RIVERSIDE, CA
NPI1255544557
Entity TypeOrganization
Authorized ContactMICHELE SEVERSON
Administrator
714-223-0396
Organization Subpart ?No
Primary Taxonomy103TP0016X Psychologist Prescribing (Medical)
Enumeration Date2007-05-07
Last Update Date2008-12-04
Business Address
PITUCK MEDICAL GROUP, INC.
5858 MAGNOLIA AVE STE C
RIVERSIDE, CA 92506-1886
Phone number: 714-223-0396
Mailing Address
PITUCK MEDICAL GROUP, INC.
432 SOMERSET DR
PLACENTIA, CA 92870-2025
Phone number: 714-223-0396
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