Provider Demographics
NPI:1326179342
Name:YOGIC REALITY, INC
Entity Type:Organization
Organization Name:YOGIC REALITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIRI ATMA
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:KHALSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-927-3480
Mailing Address - Street 1:812 DOLORES DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1612
Mailing Address - Country:US
Mailing Address - Phone:505-927-3480
Mailing Address - Fax:
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:505-927-3480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM93-155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMF29486Medicare UPIN