Shared Harvest Foundation INC
Clinic/Center, Community Health in Culver City, CA. Organization (NPI-2).
NPI number1932789757
StatusActive
Last updated in NPPESAug 4, 2022
Details
- NPI
- 1932789757
- Entity type
- Organization (NPI-2)
- Legal business name
- Shared Harvest Foundation INC
- Organization subpart
- No
- Enumeration date
- Apr 14, 2021
- Certification date
- Aug 4, 2022
- Last updated
- Aug 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QC1500X | Clinic/Center, Community Health | – | – | Yes |
Other names
- Shared Harvest Mycovidmd (Doing Business As)
Practice location
10000 Washington Blvd Ste 600Culver City, CA 90232-2783
Phone 323-880-0121 · Fax 801-665-5652
Mailing address
23934 Decorah RdDiamond Bar, CA 91765-1407
Phone 917-748-3832
Authorized official
Nanaefua Afoh-Manin
Chief Medical Officer
9177483832
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