Organization
GREATER GOOD HEALTH PC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA HASTANAN (VICE PRESIDENT)
(310) 795-8807
Entity
Organization
Contact information
Practice address
3017 EAGLE DRIVE, AMMON, ID 83406
(626) 232-3929
Mailing address
300 CONTINENTAL BLVD STE 560, EL SEGUNDO, CA 90245-5030
(626) 232-3929
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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