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General NPI Number Information
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NPI Number | 1871821850
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Entity Type | Organization
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Legal Business Name | HEALTHY SOLUTION INC
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 12/02/2009
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Provider Practice Location Address
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Address Line | 15382 W SAGE ST #103
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City | VICTORVILLE
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State | CA
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Zip | 92392-2307
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Country | US
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Telephone | 760-514-1669
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Fax |
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Provider Business Mailing Address
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Address Line | 1626 WILCOX AVE #510
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City | LOS ANGELES
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State | CA
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Zip | 90028-6206
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Country | US
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Telephone | 760-514-1669
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL W PERRY
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Credential | M.D.
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Telephone | 760-514-1669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C52983
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License Number State | CA
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