Healthcare Provider Details

I. General information

NPI: 1245847201
Provider Name (Legal Business Name): OOTIFY PLUS HEALTH GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11980 SAN VICENTE BLVD STE 910
LOS ANGELES CA
90049-6607
US

IV. Provider business mailing address

907 WESTWOOD BLVD STE 611
LOS ANGELES CA
90024-2904
US

V. Phone/Fax

Practice location:
  • Phone: 424-581-7276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL RAJESH PURI
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 310-989-2614