Organization
KETAMINE UPLIFT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEOFFERY ALAN O'NEILL MD (PRESIDENT/OWNER/MEDICAL DIRECTOR)
(310) 965-6666
Entity
Organization
Contact information
Practice address
4640 ADMIRALTY WAY # 718A, MARINA DEL REY, CA 90292-6621
(310) 280-4440
(310) 929-8436
Mailing address
3111 VIA DOLCE APT 506, MARINA DEL REY, CA 90292-5077
(310) 965-6666
(310) 929-8436
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/10/2026
Last updated
04/10/2026
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