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Organization
NEURO WELLNESS SPA, A MEDICAL PC
Active
Organization
NEURO WELLNESS SPA, A MEDICAL PC
Active
Other names
Neuro Wellness Spa
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT DOHREN (DIRECTOR OF OPERATIONS)
(858) 735-2472
Entity
Organization
Contact information
Practice address
1101 N SEPULVEDA BLVD STE 201, MANHATTAN BEACH, CA 90266-5963
(310) 545-4450
(310) 564-2295
Mailing address
1101 N SEPULVEDA BLVD STE 201, MANHATTAN BEACH, CA 90266-5963
(310) 545-4450
(310) 564-2295
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G78080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497899728
NPPES
CA
01
—
1811442767
NPPES
CA
Enumeration date
07/31/2018
Last updated
06/11/2019
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