Provider Demographics
NPI:1235892266
Name:PALM AND BIRCH HEALTH LLC
Entity Type:Organization
Organization Name:PALM AND BIRCH HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-405-1553
Mailing Address - Street 1:1441 HUNTINGTON DR # 2520
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4512
Mailing Address - Country:US
Mailing Address - Phone:323-405-1553
Mailing Address - Fax:
Practice Address - Street 1:816 STRATFORD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2805
Practice Address - Country:US
Practice Address - Phone:323-405-1553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-17
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date: