MEDICARE: NATUROPATHIC HEALTH CENTER SAN DIEGO, INC

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	175F00000X	Naturopath	ND-35	CA

General Provider Information

NPI Number	:	1689997603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATUROPATHIC HEALTH CENTER SAN DIEGO, INC

Provider Business Mailing Address
First Line	:	11939 RANCHO BERNARDO RD
Second Line	:	SUITE 120
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2073
Country	:	US
Telephone Number	:	858-618-5449
Fax Number	:	858-618-5954

Provider Business Practice Location Address
First Line	:	11939 RANCHO BERNARDO RD
Second Line	:	SUITE 120
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2073
Country	:	US
Telephone Number	:	858-618-5449
Fax Number	:	858-618-5954

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DR. IAN HUNTER MOORE
Credential	:	ND
Telephone Number	:	858-618-5449

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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