Organization
THE DUCK HOUSE, LLC
Active
Other names
The Duck House
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMAD ALI KOHZAD PHARMD (OWNER/CEO)
(714) 598-7467
Entity
Organization
Contact information
Practice address
952 DAHLIA AVE, COSTA MESA, CA 92626-1739
(714) 598-7467
Mailing address
952 DAHLIA AVE, COSTA MESA, CA 92626-1739
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300358AP
CA
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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