Healthcare Provider Details

I. General information

NPI: 1962170738
Provider Name (Legal Business Name): ENZEE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2021
Last Update Date: 09/05/2021
Certification Date: 09/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3267 BRIGGS AVE # B
ALAMEDA CA
94501-4802
US

IV. Provider business mailing address

3275 BRIGGS AVE
ALAMEDA CA
94501-4802
US

V. Phone/Fax

Practice location:
  • Phone: 510-239-7455
  • Fax:
Mailing address:
  • Phone: 510-239-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREG MOGEL
Title or Position: PRESIDENT
Credential: MD
Phone: 805-807-1871