Healthcare Provider Details

I. General information

NPI: 1790345296
Provider Name (Legal Business Name): HEALTH AI MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 KUHN DR
CHULA VISTA CA
91914-3563
US

IV. Provider business mailing address

881 KUHN DR
CHULA VISTA CA
91914-3563
US

V. Phone/Fax

Practice location:
  • Phone: 619-423-8200
  • Fax: 619-423-8205
Mailing address:
  • Phone: 619-423-8200
  • Fax: 619-423-8205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GREENHALGH
Title or Position: OWNER
Credential:
Phone: 619-423-8200