| Bastyr University Clinic | |
|
4106 Sorrento Valley Blvd San Diego CA 92121-1407 | |
| (858) 246-9730 | |
| (858) 246-9710 |
| Full Name | Bastyr University Clinic |
|---|---|
| Speciality | Naturopath |
| Location | 4106 Sorrento Valley Blvd, San Diego, California |
| Authorized Official Name and Position | Moira Pyle Fitzpatrick (VICE PRESIDENT) |
| Authorized Official Contact | 8582469701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bastyr University Clinic 4106 Sorrento Valley Blvd San Diego CA 92121-1407 Ph: (858) 246-9730 | Bastyr University Clinic 4106 Sorrento Valley Blvd San Diego CA 92121-1407 Ph: (858) 246-9730 |
| NPI Number | 1104160043 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104160043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PSY11413 (California) | Secondary |
| 175F00000X | Naturopath | ND-556 (California) | Primary |
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