Azusa Pacific University
NPI #1104002146 in Azusa, California
Provider Information
- NPI Number
- 1104002146
- Entity Type
- Organization
- Organization Name
- Azusa Pacific University
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jan 19, 2008
- Last Updated
- Jan 19, 2008
Practice Location
- Address
- 918 E ALOSTA AVE
- City
- Azusa
- State
- California
- ZIP Code
- 91702-2709
- Phone
- (626) 815-5421
Authorized Official
- Name
- DR. MARK DICKERSON
- Title
- VICE PRESIDENT
- Phone
- (626) 387-5763
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
| Community/Behavioral Health |
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