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General NPI Number Information
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NPI Number | 1649713447
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Entity Type | Organization
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Legal Business Name | HYGEIA II MEDICAL GROUP, IN.C
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 2356 CANYON DR
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City | SAINT CHARLES
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State | MO
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Zip | 63303-6255
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Country | US
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Telephone | 714-515-7571
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Fax | 714-494-8571
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Provider Business Mailing Address
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Address Line | 6241 YARROW DR SUITE A
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City | CARLSBAD
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State | CA
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Zip | 92011-1541
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Country | US
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Telephone | 714-515-7571
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Fax | 714-494-8571
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRETT NAKFOOR
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Credential |
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Telephone | 714-515-7571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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