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Organization
RIVER STREET INTEGRATIVE MEDICINE, INC.
Active
Organization
RIVER STREET INTEGRATIVE MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESTER JAY BRODIE M.D. (MEDICAL DOCTOR)
(831) 457-2000
Entity
Organization
Contact information
Practice address
700 RIVER ST, SANTA CRUZ, CA 95060-2748
(831) 457-2000
(831) 457-2140
Mailing address
700 RIVER ST, SANTA CRUZ, CA 95060-2748
(831) 457-2000
(831) 457-2140
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A79910
CA
Other
Enumeration date
12/26/2012
Last updated
06/13/2013
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