Healthcare Provider Details

I. General information

NPI: 1184007247
Provider Name (Legal Business Name): TOBIN HOLISTIC MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N BREA BLVD STE F
BREA CA
92821-3354
US

IV. Provider business mailing address

710 N BREA BLVD STE F
BREA CA
92821-3354
US

V. Phone/Fax

Practice location:
  • Phone: 714-256-2287
  • Fax:
Mailing address:
  • Phone: 714-256-2287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number11035
License Number StateCA

VIII. Authorized Official

Name: MARY TOBIN
Title or Position: DIRECTOR
Credential:
Phone: 714-256-2287