Healthcare Provider Details

I. General information

NPI: 1497518583
Provider Name (Legal Business Name): SUMMIT NATUROPATHIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 IRON POINT RD STE 120
FOLSOM CA
95630-8835
US

IV. Provider business mailing address

1845 IRON POINT RD STE 120
FOLSOM CA
95630-8835
US

V. Phone/Fax

Practice location:
  • Phone: 530-214-0440
  • Fax: 844-444-0920
Mailing address:
  • Phone: 530-214-0440
  • Fax: 844-444-0920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT HALLMEYER
Title or Position: COO/CFO/PRACTICE MANAGER
Credential:
Phone: 530-214-0440