Provider Demographics
NPI:1598347833
Name:STEWART, COREY A (ND)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:A
Last Name:STEWART
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 STEVENS AVE
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2422
Mailing Address - Country:US
Mailing Address - Phone:858-449-8240
Mailing Address - Fax:858-350-6775
Practice Address - Street 1:634 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2422
Practice Address - Country:US
Practice Address - Phone:858-350-6290
Practice Address - Fax:858-350-6775
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1241175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath