Integrative Wellness Medical Group
Family Medicine in Solana Beach, CA. Organization (NPI-2).
NPI number1609211648
StatusActive
Last updated in NPPESMay 3, 2013
Details
- NPI
- 1609211648
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrative Wellness Medical Group
- Organization subpart
- No
- Enumeration date
- May 3, 2013
- Last updated
- May 3, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 104552 | CA | Yes |
| 111N00000X | Chiropractor | CA30803 | CA | |
| 207RE0101X | Internal Medicine, Endocrinology, Diabetes & Metabolism | A96446 | CA | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | A104552 | CA |
Practice location
125 N Acacia AveSuite 111
Solana Beach, CA 92075-1165
Phone 858-444-0111 · Fax 858-794-2722
Mailing address
125 N AcaciaSuite 111
Solana Beach, CA 92075
Phone 858-444-0111 · Fax 858-794-2722
Authorized official
Kerrin Moote
Office Manager
8584440111
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