Provider Demographics
NPI:1043768856
Name:H.O.P.E. FOR HEALING INSTITUTE (A 501C3 NOT FOR PROFIT)
Entity Type:Organization
Organization Name:H.O.P.E. FOR HEALING INSTITUTE (A 501C3 NOT FOR PROFIT)
Other - Org Name:HYPERBARIC OXYGEN THERAPY OF MARIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:415-785-8652
Mailing Address - Street 1:900 LARKSPUR LANDING CIR
Mailing Address - Street 2:SUITE # 115
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1757
Mailing Address - Country:US
Mailing Address - Phone:415-785-8652
Mailing Address - Fax:415-785-8697
Practice Address - Street 1:900 LARKSPUR LANDING CIR
Practice Address - Street 2:SUITE # 115
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1757
Practice Address - Country:US
Practice Address - Phone:415-785-8652
Practice Address - Fax:415-785-8697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10041261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty