Provider Demographics
NPI:1316154172
Name:PSYCHSERV MEDICAL CORPORATION
Entity type:Organization
Organization Name:PSYCHSERV MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZILBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-927-4421
Mailing Address - Street 1:520 TAMALPAIS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1558
Mailing Address - Country:US
Mailing Address - Phone:415-927-4421
Mailing Address - Fax:415-464-8774
Practice Address - Street 1:520 TAMALPAIS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1558
Practice Address - Country:US
Practice Address - Phone:415-927-4421
Practice Address - Fax:415-464-8774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty