Healthcare Provider Details

I. General information

NPI: 1528170446
Provider Name (Legal Business Name): GOOD HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 E YORBA LINDA BLVD STE 209
PLACENTIA CA
92870-3728
US

IV. Provider business mailing address

410 CLOVERLEAF DR
BALDWIN PARK CA
91706-6511
US

V. Phone/Fax

Practice location:
  • Phone: 714-993-9370
  • Fax: 714-572-9453
Mailing address:
  • Phone: 714-993-9370
  • Fax: 714-572-9453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47438
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN SAMUEL
Title or Position: OWNER
Credential:
Phone: 714-961-7930