Provider Demographics
NPI:1124332754
Name:NIRVANA HYPERBARIC INSTITUTE INC
Entity type:Organization
Organization Name:NIRVANA HYPERBARIC INSTITUTE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-642-0533
Mailing Address - Street 1:2028 VILLAGE LN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-3221
Mailing Address - Country:US
Mailing Address - Phone:805-693-8100
Mailing Address - Fax:805-693-8107
Practice Address - Street 1:2028 VILLAGE LN
Practice Address - Street 2:SUITE 104
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3221
Practice Address - Country:US
Practice Address - Phone:805-693-8100
Practice Address - Fax:805-693-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty