Provider Demographics
NPI:1558415380
Name:STILLPOINT CENTER FOR INTEGRATIVE MEDICINE
Entity Type:Organization
Organization Name:STILLPOINT CENTER FOR INTEGRATIVE MEDICINE
Other - Org Name:UNIVERSAL HEALTH ASSOCIATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:WOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:951-461-4800
Mailing Address - Street 1:41661 ENTERPRISE CIR N
Mailing Address - Street 2:STE 113
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5629
Mailing Address - Country:US
Mailing Address - Phone:951-461-4800
Mailing Address - Fax:951-461-4560
Practice Address - Street 1:41661 ENTERPRISE CIR N
Practice Address - Street 2:SUITE # 113
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5629
Practice Address - Country:US
Practice Address - Phone:951-461-4800
Practice Address - Fax:951-461-4560
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSAL HEALTH ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-22
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7003208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty