Provider Demographics
NPI:1255148060
Name:GOLDEN STATE INTEGRATIVE HEALTH, NATUROPATHIC PC
Entity type:Organization
Organization Name:GOLDEN STATE INTEGRATIVE HEALTH, NATUROPATHIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, NATUROPATHIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEENEGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:424-599-0158
Mailing Address - Street 1:8023 BEVERLY BLVD STE 1-1137
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4539
Mailing Address - Country:US
Mailing Address - Phone:424-599-0158
Mailing Address - Fax:877-286-4095
Practice Address - Street 1:8023 BEVERLY BLVD STE 1-1137
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4539
Practice Address - Country:US
Practice Address - Phone:424-599-0158
Practice Address - Fax:877-286-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center