Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 10-1205 | AZ |
NPI | 1083923478 |
---|---|
Provider Name | Dr. Heath Mccormick Mcallister |
First Address | Los Angeles, CA 90049-6535 |
Second Address | Los Angeles, CA 90049-6535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2010 |
Last Update Date | 14/02/2019 |