=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477273332
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA CAROLINE GEORGE ND, BSC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2022
-----------------------------------------------------
Last Update Date | 08/31/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28801 GOLDEN MEADOW DR.
-----------------------------------------------------
City | RANCHO PALOS VERDES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90275
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 604-715-1887
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5605 SUMAC PLACE
-----------------------------------------------------
City | NORTH VANCOUVER
-----------------------------------------------------
State | BRITISH COLUMBIA
-----------------------------------------------------
Zip | V7R4T6
-----------------------------------------------------
Country | CA
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number | CA1343
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------