Healthcare Provider Details

I. General information

NPI: 1932307477
Provider Name (Legal Business Name): JOSEPH CLINTON COMSTOCK JR. N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 W MAGNOLIA BLVD
BURBANK CA
91505-3030
US

IV. Provider business mailing address

2515 W MAGNOLIA BLVD
BURBANK CA
91505-3030
US

V. Phone/Fax

Practice location:
  • Phone: 310-281-8538
  • Fax: 818-845-1608
Mailing address:
  • Phone: 310-281-8538
  • Fax: 818-845-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-138
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: