Azusa Pacific University

Organization Active NPI Community/Behavioral Health Agency · Azusa, CA

NPI 1104002146 · NPPES record last updated Jan 19, 2008

Key facts

NPI
1104002146
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
AZUSA PACIFIC UNIVERSITY
Practice address
918 E Alosta Ave
Azusa, CA 91702-2709
Phone
(626) 815-5421
NPI assigned
Jan 19, 2008
Organization subpart
No

Authorized official

Name
Dr. Mark Dickerson
Title
Vice President
Phone
(626) 387-5763

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

918 E Alosta Ave
Azusa, CA 91702
Phone (626) 815-5421

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

918 E Alosta Ave
Azusa, CA 91702-2709

Mailing address

901 E Alosta Ave
Azusa, CA 91702-2701
Phone (626) 815-5421

Other providers in Azusa, CA

All providers in Azusa, CA · Community/Behavioral Health Agency in California

Sources for this page

Verify at the official NPI Registry.