# ALTERED STATES RESEARCH GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ASRG
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396995718
- **Authorized official:** DR. CHARLES I. KNOLL M.D. (DIRECTOR)
- **Authorized official phone:** (619) 481-8416

## Contact information

- **Practice address:** 3511 CAMINO DEL RIO S, SUITE 404, SAN DIEGO, CA 92108-4003
- **Practice address phone:** (619) 481-8416
- **Practice address fax:** (619) 516-3993
- **Mailing address:** 3511 CAMINO DEL RIO S, SUITE 404, SAN DIEGO, CA 92108-4003
- **Mailing address phone:** (619) 481-8416
- **Mailing address fax:** (619) 516-3993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | A100046 | CA | Yes |

## Other

- **Enumeration date:** 09/22/2008
- **Last updated:** 09/22/2008