Provider Demographics
NPI:1992834899
Name:INTEGRATIVE HEALTH CARE CENTER MOVE USA, LLC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTH CARE CENTER MOVE USA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-783-2773
Mailing Address - Street 1:22807 BARTON RD
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5208
Mailing Address - Country:US
Mailing Address - Phone:909-783-2773
Mailing Address - Fax:909-783-6625
Practice Address - Street 1:22807 BARTON RD
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5208
Practice Address - Country:US
Practice Address - Phone:909-783-2773
Practice Address - Fax:909-783-6625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00090411174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty