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General NPI Number Information
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NPI Number | 1740806306
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Entity Type | Organization
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Legal Business Name | PREVENTATIVE MEDICINE INC
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 16400 LARK AVE STE 100
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City | LOS GATOS
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State | CA
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Zip | 95032-2563
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Country | US
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Telephone | 408-992-5141
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Fax | 650-999-9134
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Provider Business Mailing Address
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Address Line | 16400 LARK AVE STE 100
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City | LOS GATOS
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State | CA
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Zip | 95032-2563
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Country | US
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Telephone | 408-992-5141
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Fax | 650-999-9134
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Authorized Official
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Title or Position | CEO, FOUNDER
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Name | DR. SEPIDEH MOAYED
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Credential | MD
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Telephone | 408-992-5141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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