Provider Demographics
NPI:1619444569
Name:OPTIMIZED HEALTH LLC
Entity Type:Organization
Organization Name:OPTIMIZED HEALTH LLC
Other - Org Name:OPTIMIZED HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL AFFAIRS MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-255-4242
Mailing Address - Street 1:120 BALDWIN AVE UNIT 790314
Mailing Address - Street 2:
Mailing Address - City:PAIA
Mailing Address - State:HI
Mailing Address - Zip Code:96779-3014
Mailing Address - Country:US
Mailing Address - Phone:888-982-4353
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 1114
Practice Address - Street 2:#23464
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:888-982-4353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty