Healthcare Provider Details
I. General information
NPI: 1710823992
Provider Name (Legal Business Name): FUTURENOMIC RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US
IV. Provider business mailing address
41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US
V. Phone/Fax
- Phone: 415-424-3467
- Fax:
- Phone: 415-424-3467
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHASU
ADON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 415-424-3467