Healthcare Provider Details
I. General information
NPI: 1295342830
Provider Name (Legal Business Name): CURATIVE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2020
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
279 E ARROW HWY STE 201
SAN DIMAS CA
91773-3320
US
IV. Provider business mailing address
430 S CATARACT AVE
SAN DIMAS CA
91773-2902
US
V. Phone/Fax
- Phone: 424-645-7575
- Fax:
- Phone: 888-702-9042
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0500X |
| Taxonomy | Preventive Medicine/Occupational Environmental Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
FREDERICK
TURNER
Title or Position: CEO
Credential:
Phone: 650-713-8928