Healthcare Provider Details
I. General information
NPI: 1386950897
Provider Name (Legal Business Name): MR. IZMAEL DAVID ARKIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/20/2010
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
290 E GOBBI ST
UKIAH CA
95482-5559
US
IV. Provider business mailing address
4161 BLACK BART TRL
REDWOOD VALLEY CA
95470-6237
US
V. Phone/Fax
- Phone: 707-463-3300
- Fax:
- Phone: 707-485-4064
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: