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General NPI Number Information
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NPI Number | 1124557996
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST NATUROPATHIC HEALTH
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 06/06/2017
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Provider Practice Location Address
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Address Line | 2007 S COAST HWY STE 100
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-3658
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Country | US
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Telephone | 949-416-4670
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Fax | 949-416-4670
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Provider Business Mailing Address
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Address Line | 24581 HARBOR VIEW DR UNIT A
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City | DANA POINT
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State | CA
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Zip | 92629-1750
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Country | US
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Telephone | 949-416-4670
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | HELENE PULNIK
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Credential | ND
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Telephone | 949-416-4670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NDF636
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License Number State | CA
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