Healthcare Provider Details

I. General information

NPI: 1275876146
Provider Name (Legal Business Name): HEALTH AT LAST COSTA MESA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2013
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 NEWPORT BLVD SUITE D251
COSTA MESA CA
92627-5031
US

IV. Provider business mailing address

2980 N BEVERLY GLEN CIR SUITE 301
LOS ANGELES CA
90077-1726
US

V. Phone/Fax

Practice location:
  • Phone: 949-515-4006
  • Fax:
Mailing address:
  • Phone: 310-474-9809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNA D. STEINER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 949-515-4006