Provider Demographics
NPI:1255927133
Name:MEHMEDI, ADRIAN (ND)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:MEHMEDI
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 MISSION BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-7774
Mailing Address - Country:US
Mailing Address - Phone:815-979-5709
Mailing Address - Fax:
Practice Address - Street 1:3239 MISSION BLVD APT 1
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-7774
Practice Address - Country:US
Practice Address - Phone:815-979-5709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1198175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty