Provider Demographics
NPI:1952624223
Name:CALIFORNIA NEUROHEALTH
Entity Type:Organization
Organization Name:CALIFORNIA NEUROHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:DEMARTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-269-9426
Mailing Address - Street 1:1633 PEREIRA DR
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-6830
Mailing Address - Country:US
Mailing Address - Phone:650-269-9426
Mailing Address - Fax:650-488-7117
Practice Address - Street 1:1411 MARSH ST STE 106
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2967
Practice Address - Country:US
Practice Address - Phone:805-439-1581
Practice Address - Fax:650-488-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29961111NN0400X
CAAC12645171100000X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty