Organization
FUNDAMENTAL HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREN CHRISTOPHER MISARESH MBA (CEO)
(213) 364-2906
Entity
Organization
Contact information
Practice address
10323 SANTA MONICA BLVD, #109, LOS ANGELES, CA 90025-6071
(213) 364-2906
Mailing address
10323 SANTA MONICA BLVD, #109, LOS ANGELES, CA 90025-6071
(213) 364-2906
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
G080589
CA
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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