Organization
HEADLIGHT HEALTH MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHASHITA INAMDAR MD (OWNER)
(619) 629-1719
Entity
Organization
Contact information
Practice address
5060 SHOREHAM PL STE 330, SAN DIEGO, CA 92122-5976
(866) 657-6592
Mailing address
PO BOX 65737, SALT LAKE CITY, UT 84165-0737
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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