Provider Demographics
NPI:1386146496
Name:ALLIANCE PSYCHIATRIC GROUP INC A MEDICAL CORPORATION
Entity type:Organization
Organization Name:ALLIANCE PSYCHIATRIC GROUP INC A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:949-574-3341
Mailing Address - Street 1:PO BOX 6040
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92616-6040
Mailing Address - Country:US
Mailing Address - Phone:714-769-6090
Mailing Address - Fax:
Practice Address - Street 1:2082 BUSINESS CENTER DR STE 255
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1162
Practice Address - Country:US
Practice Address - Phone:714-769-6090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
CA95003733363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty