Provider Demographics
NPI:1578217949
Name:MIND-BODY INTEGRATION & HEALING, INC
Entity Type:Organization
Organization Name:MIND-BODY INTEGRATION & HEALING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:MANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-243-8310
Mailing Address - Street 1:5290 OVERPASS RD STE 128
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-4048
Mailing Address - Country:US
Mailing Address - Phone:805-679-3034
Mailing Address - Fax:
Practice Address - Street 1:5290 OVERPASS RD STE 128
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-4048
Practice Address - Country:US
Practice Address - Phone:805-679-3034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1508094723OtherNPPES
CA1114244688OtherNPPES