Provider Demographics
NPI:1619243656
Name:EQUINOX NATUROPATHIC MEDICINE, PC
Entity Type:Organization
Organization Name:EQUINOX NATUROPATHIC MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MATTEUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:805-560-0111
Mailing Address - Street 1:924 ANACAPA ST
Mailing Address - Street 2:SUITE B3
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2115
Mailing Address - Country:US
Mailing Address - Phone:805-560-0111
Mailing Address - Fax:805-258-5132
Practice Address - Street 1:924 ANACAPA ST
Practice Address - Street 2:SUITE B3
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2115
Practice Address - Country:US
Practice Address - Phone:805-560-0111
Practice Address - Fax:805-258-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-519175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty