Provider Demographics
NPI:1740214691
Name:GARFIELD HOLISTIC MEDICAL GROUP
Entity Type:Organization
Organization Name:GARFIELD HOLISTIC MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMISLAV
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMUNOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:626-280-4884
Mailing Address - Street 1:1341 BROOKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3221
Mailing Address - Country:US
Mailing Address - Phone:562-818-2974
Mailing Address - Fax:
Practice Address - Street 1:405 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1201
Practice Address - Country:US
Practice Address - Phone:626-280-4884
Practice Address - Fax:626-280-4886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12688174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT12688Medicare ID - Type Unspecified