Healthcare Provider Details

I. General information

NPI: 1952624223
Provider Name (Legal Business Name): CALIFORNIA NEUROHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 MARSH ST STE 106
SAN LUIS OBISPO CA
93401-2967
US

IV. Provider business mailing address

1633 PEREIRA DR
SAN LUIS OBISPO CA
93405-6830
US

V. Phone/Fax

Practice location:
  • Phone: 805-439-1581
  • Fax: 650-488-7117
Mailing address:
  • Phone: 650-269-9426
  • Fax: 650-488-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC29961
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12645
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER EVAN DEMARTINI
Title or Position: PARTNER
Credential: D.C.
Phone: 650-269-9426