| NPI | 1386514057 |
|---|---|
| Doing Business As | MEDPROV |
| Entity Type | Organization |
| Authorized Contact | HAYDEN MOSER Billing Director 949-446-6280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-11-07 |
| Last Update Date | 2025-11-07 |