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NPI Code Detail

MEDICARE: INNDYDOZZER

MEDICARE: INNDYDOZZER
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
1175F00000XNaturopath

General Provider Information

NPI Number : 1285008748
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNDYDOZZER
Provider Business Mailing Address
First Line : 1112 MONTANA AVE
Second Line : SUITE 243
City : SANTA MONICA
State : CA
Zip : 90403-1652
Country : US
Telephone Number : 310-358-2991
Fax Number :
Provider Business Practice Location Address
First Line : 1112 MONTANA AVE
Second Line : SUITE 243
City : SANTA MONICA
State : CA
Zip : 90403-1652
Country : US
Telephone Number : 310-358-2991
Fax Number :
Authorized Official
Title or Position : CEO
Name : MS. MARINA BENVENGA
Credential :
Telephone Number : 310-358-2991
Provider Enumeration Date : 11/20/2015
Last Update Date : 11/20/2015

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Directions to “INNDYDOZZER ” Practice Location

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