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Organization
INTEGRATIVE WELLNESS MEDICAL GROUP
Active
Organization
INTEGRATIVE WELLNESS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRIN MOOTE (OFFICE MANAGER)
(858) 444-0111
Entity
Organization
Contact information
Practice address
125 N ACACIA AVE, SUITE 111, SOLANA BEACH, CA 92075-1165
(858) 444-0111
(858) 794-2722
Mailing address
125 N ACACIA, SUITE 111, SOLANA BEACH, CA 92075
(858) 444-0111
(858) 794-2722
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CA30803
CA
207Q00000X
Family Medicine Physician
Primary
104552
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
A96446
CA
2084P0800X
Psychiatry Physician
A104552
CA
Other
Enumeration date
05/03/2013
Last updated
05/03/2013
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