Provider Demographics
NPI:1083923478
Name:MCALLISTER, HEATH MCCORMICK (ND)
Entity Type:Individual
Prefix:DR
First Name:HEATH
Middle Name:MCCORMICK
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11640 SAN VICENTE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6535
Mailing Address - Country:US
Mailing Address - Phone:310-820-7925
Mailing Address - Fax:
Practice Address - Street 1:11640 SAN VICENTE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6535
Practice Address - Country:US
Practice Address - Phone:310-820-7925
Practice Address - Fax:310-820-7949
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10-1205175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath