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
2230 N RESERVE ST STE 110, MISSOULA, MT 59808-1364
(310) 658-3775
Mailing address
300 CONTINENTAL BLVD STE 635, EL SEGUNDO, CA 90245-5040
(310) 658-3775
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/30/2023
Last updated
10/31/2023
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