Provider Demographics
NPI:1699339044
Name:INTEGRATIVE HEALTH INSTITUTES, A NATUROPATHIC CORPORATION
Entity type:Organization
Organization Name:INTEGRATIVE HEALTH INSTITUTES, A NATUROPATHIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:DAWN TREBILCOCK
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:310-526-7328
Mailing Address - Street 1:689 W FOOTHILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3400
Mailing Address - Country:US
Mailing Address - Phone:310-526-7328
Mailing Address - Fax:
Practice Address - Street 1:689 W FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3400
Practice Address - Country:US
Practice Address - Phone:310-526-7328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0009992225OtherNONE