Healthcare Provider Details

I. General information

NPI: 1760204192
Provider Name (Legal Business Name): CUTLIFF ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4348 EAST AVE S4
PALMDALE CA
93552
US

IV. Provider business mailing address

11586 MONTE ISOLA ST
LAS VEGAS NV
89141-3296
US

V. Phone/Fax

Practice location:
  • Phone: 305-331-2428
  • Fax:
Mailing address:
  • Phone: 305-331-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERRELLE CUTLIFF
Title or Position: OWNER
Credential:
Phone: 305-331-2428