Doctor Name: | MARCO PARDO |
NPI Number: | 1013268168 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CATC-IV |
License Number: | |
Business Practice Address: | 11027 Burbank Blvd North Hollywood, CA - 916012431 |
Business Phone Number: | 8189858323 |
Business Fax Number: | 8189854297 |
Mailing Address: | 11027 Burbank Blvd, NORTH HOLLYWOOD |
State: | CA |
Postal Code: | 916012431 |
Phone Number: | 8189858323 |
Fax Number: | 8189854297 |
NPI Enumeration Date: | 09/28/2012 |
NPI Last Update Date: | 10/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |