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General NPI Number Information
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NPI Number | 1932930120
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Entity Type | Organization
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Legal Business Name | CALIFORNIA HEALING HORIZONS
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 1650 SPRUCE ST STE 240
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City | RIVERSIDE
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State | CA
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Zip | 92507-7403
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Country | US
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Telephone | 909-856-5904
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Fax |
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Provider Business Mailing Address
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Address Line | 967 KENDALL DR STE A-515
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4306
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Country | US
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Telephone | 909-856-5904
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. INA CREEKBAUM
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Credential |
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Telephone | 909-856-5904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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