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General NPI Number Information
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NPI Number | 1255148060
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Entity Type | Organization
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Legal Business Name | GOLDEN STATE INTEGRATIVE HEALTH, NATUROPATHIC PC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 8023 BEVERLY BLVD STE 1-1137
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City | LOS ANGELES
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State | CA
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Zip | 90048-4539
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Country | US
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Telephone | 424-599-0158
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Fax | 877-286-4095
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Provider Business Mailing Address
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Address Line | 8023 BEVERLY BLVD STE 1-1137
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City | LOS ANGELES
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State | CA
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Zip | 90048-4539
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Country | US
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Telephone | 424-599-0158
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Fax | 877-286-4095
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Authorized Official
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Title or Position | CEO, NATUROPATHIC DOCTOR
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Name | DR. STEPHEN MEENEGHAN
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Credential | ND
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Telephone | 424-599-0158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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