Provider Demographics
NPI:1386180966
Name:SOBER DASHBOARD
Entity Type:Organization
Organization Name:SOBER DASHBOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RISHI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATRI
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:310-740-0366
Mailing Address - Street 1:4232 LAS VIRGENES RD STE B
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3589
Mailing Address - Country:US
Mailing Address - Phone:310-740-0366
Mailing Address - Fax:
Practice Address - Street 1:4232 LAS VIRGENES RD STE B
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3589
Practice Address - Country:US
Practice Address - Phone:310-740-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health