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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