Organization
SHORELINE WELLNESS MULTI
Active
Other names
shoreline Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHU KATAKIA M.D. (MEDICAL DIRECTOR)
(424) 287-5555
Entity
Organization
Contact information
Practice address
1360 W 6TH ST STE 165, SAN PEDRO, CA 90732-3540
(424) 287-5555
(310) 872-5508
Mailing address
1360 W 6TH ST STE 165, SAN PEDRO, CA 90732-3540
(424) 287-5555
(310) 872-5508
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
CA
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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