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Contact Information

360 MIND
1328 22ND ST
SANTA MONICA, CA90404-2032
 Phone: 310-582-7450
 Fax: 310-582-7495
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for 360 MIND · (Female)

NPI Number 1366753683
Status Active
Credentials
Entity Individual
Enumeration date 07/01/2010
Last updated 07/01/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • CA License # C53853
  • CA License # G77318
  • CA License # G88653
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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