Healthcare Provider Details

I. General information

NPI: 1730524786
Provider Name (Legal Business Name): EARENDIL MYCAL SPINDELILUS D.N.M., M.H. C.R.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2013
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 CHURN CREEK RD SUITE B
REDDING CA
96002-2502
US

IV. Provider business mailing address

PO BOX 266
IGO CA
96047-0266
US

V. Phone/Fax

Practice location:
  • Phone: 530-722-6728
  • Fax:
Mailing address:
  • Phone: 530-722-6728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: