Provider Demographics
NPI:1689295214
Name:WEST COAST EQUITY BUILDER LLC
Entity Type:Organization
Organization Name:WEST COAST EQUITY BUILDER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LURLINE
Authorized Official - Last Name:KHATIB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-312-4038
Mailing Address - Street 1:700 E REDLANDS BLVD # U-748
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6109
Mailing Address - Country:US
Mailing Address - Phone:909-227-0120
Mailing Address - Fax:
Practice Address - Street 1:700 E REDLANDS BLVD # U-748
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6109
Practice Address - Country:US
Practice Address - Phone:909-227-0120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable