Basic Information
| Provider Information | |||||||||
| NPI: | 1801255591 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CONSUMERHEALTH, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 SPECTRUM CENTER DRIVE | ||||||||
| Address2: | SUITE 1500 | ||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926183298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145786358 | ||||||||
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| Practice Location | |||||||||
| Address1: | 26477 GOLDEN VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913502973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612531010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2016 | ||||||||
| LastUpdateDate: | 10/05/2017 | ||||||||
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| AuthorizedOfficialLastName: | SCHMIDT | ||||||||
| AuthorizedOfficialFirstName: | LORILEE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7145786358 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CONSUMERHEALTH, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223D0001X | Y | 193200000X MULTI-SPECIALTY GROUP | Dental Providers | Dentist | Dental Public Health |
No ID Information.