Healthcare Provider Details

I. General information

NPI: 1043674815
Provider Name (Legal Business Name): HELIX MOBILE WELLNESS AND RESEARCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 POST ST STE 239
SAN FRANCISCO CA
94102-1403
US

IV. Provider business mailing address

490 POST ST STE 239
SAN FRANCISCO CA
94102-1403
US

V. Phone/Fax

Practice location:
  • Phone: 415-656-8318
  • Fax: 310-314-2732
Mailing address:
  • Phone: 415-656-8318
  • Fax: 310-314-2732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number05D2103632
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateCA

VIII. Authorized Official

Name: MIGUEL ALI HASSAN
Title or Position: PRESIDENT
Credential:
Phone: 949-355-2488