Provider Demographics
NPI:1477213445
Name:INTEGRATIVE HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTHCARE SERVICES LLC
Other - Org Name:I HEAL MED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KALSI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:925-570-1472
Mailing Address - Street 1:300 MAIN STREET
Mailing Address - Street 2:SUITE 21 #887
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1040
Mailing Address - Country:US
Mailing Address - Phone:559-550-4325
Mailing Address - Fax:559-550-4324
Practice Address - Street 1:300 MAIN STREET
Practice Address - Street 2:SUITE 21 #887
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1040
Practice Address - Country:US
Practice Address - Phone:855-432-5365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1477729374OtherSOSTRE
1649430950OtherKALSI NPI
1609380104OtherASHLEES NPI
1801362025OtherOSCAR MOYA PA-C