Organization Name: | SEA STARS WELLNESS CENTER |
NPI Number: | 1134362346 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIA D NAVARRO (OWNER) |
Mailing Address: | 1775 E Lincoln Ave Ste 101 Anaheim |
State: | CA US |
Postal Code: | 928054300 |
Phone Number: | 7143000609 |
Fax Number: | 7143000610 |
NPI Enumeration Date: | 04/17/2009 |
NPI Last Update Date: | 04/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |