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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

NPI # 1366753683
LBN Legal business name 360 MIND
Authorized official KATHERINE KERR - (VP OF OPERATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 07/01/2010
Last updated 07/01/2010 - About 16 years ago
Identifiers
CA License # C53853
CA License # G77318
CA License # G88653
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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