MEDICARE: GOLDEN STATE INTEGRATIVE HEALTH, NATUROPATHIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1255148060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN STATE INTEGRATIVE HEALTH, NATUROPATHIC PC

Provider Business Mailing Address
First Line	:	8023 BEVERLY BLVD STE 1-1137
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4539
Country	:	US
Telephone Number	:	424-599-0158
Fax Number	:	877-286-4095

Provider Business Practice Location Address
First Line	:	8023 BEVERLY BLVD STE 1-1137
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4539
Country	:	US
Telephone Number	:	424-599-0158
Fax Number	:	877-286-4095

Authorized Official
Title or Position	:	CEO, NATUROPATHIC DOCTOR
Name	:	DR. STEPHEN MEENEGHAN
Credential	:	ND
Telephone Number	:	424-599-0158

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	12/16/2024

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