Provider Demographics
NPI:1437659794
Name:SAN DIEGO HOMEOPATHY
Entity Type:Organization
Organization Name:SAN DIEGO HOMEOPATHY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:TRAUB
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MTECH (HOM), CCH
Authorized Official - Phone:619-838-5583
Mailing Address - Street 1:4125 SORRENTO VALLEY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1423
Mailing Address - Country:US
Mailing Address - Phone:858-531-5279
Mailing Address - Fax:
Practice Address - Street 1:4125 SORRENTO VALLEY BLVD STE A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1423
Practice Address - Country:US
Practice Address - Phone:858-531-5279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Single Specialty