Organization
SOLANDSOUL MEDICAL GROUP, A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Luzwave Integrative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA MACK (ADMINISTRATOR)
(949) 527-6400
Entity
Organization
Contact information
Practice address
14642 NEWPORT AVE STE 105, TUSTIN, CA 92780-6058
(949) 527-6410
(714) 486-2309
Mailing address
14642 NEWPORT AVE STE 105, TUSTIN, CA 92780-6058
(949) 527-6400
(714) 486-2309
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/15/2019
Last updated
03/17/2020
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