Healthcare Provider Details

I. General information

NPI: 1588544555
Provider Name (Legal Business Name): BE WELL BRAIN HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2869 HISTORIC DECATUR RD
SAN DIEGO CA
92106-6176
US

IV. Provider business mailing address

2869 HISTORIC DECATUR RD
SAN DIEGO CA
92106-6176
US

V. Phone/Fax

Practice location:
  • Phone: 858-291-0036
  • Fax: 858-724-3655
Mailing address:
  • Phone: 858-291-0036
  • Fax: 858-724-3655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINA M CHOPIN
Title or Position: OWNER, CEO
Credential:
Phone: 858-291-0036