Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1158 | CA |
NPI | 1063003200 |
---|---|
Provider Name | Dr. Megan Marie |
First Address | San Diego, CA 92130 |
Second Address | San Diego, CA 92130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2021 |
Last Update Date | 31/01/2021 |