Provider Demographics
NPI:1750798211
Name:WE RECOVER MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:WE RECOVER MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTING MEDICAL DIRECTOR/ PSYCHI
Authorized Official - Prefix:DR
Authorized Official - First Name:KEERTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-685-2022
Mailing Address - Street 1:41655 DATE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-7040
Mailing Address - Country:US
Mailing Address - Phone:866-920-1275
Mailing Address - Fax:866-632-9472
Practice Address - Street 1:41655 DATE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7040
Practice Address - Country:US
Practice Address - Phone:866-920-1275
Practice Address - Fax:866-632-9472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty