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General NPI Number Information
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NPI Number | 1609211457
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Entity Type | Organization
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Legal Business Name | AN OPTIMAL YOU
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 29995 TECHNOLOGY DR SUITE 203
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City | MURRIETA
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State | CA
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Zip | 92563-2632
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Country | US
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Telephone | 951-461-3021
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Fax | 951-461-8898
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Provider Business Mailing Address
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Address Line | 29995 TECHNOLOGY DR SUITE 203
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City | MURRIETA
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State | CA
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Zip | 92563-2632
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Country | US
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Telephone | 951-461-3021
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Fax | 951-461-8898
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURIE BLANSCET
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Credential | D.O
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Telephone | 951-461-3021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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