HEALING SOURCE MEDICAL, INC. (NPI# 1649781121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649781121 |
| Entity Type | Organization |
| Organization Name | HEALING SOURCE MEDICAL, INC. |
| Practice Address |
1601 Dove St Ste 185 Newport Beach CA 92660-2441 |
| Practice Telephone | 9494162183 |
| Mailing Telephone | 9494162183 |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2017-10-24 |
| Authorized Official Name | CHARLES CHANEY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9494162183 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
1601 DOVE ST STE 185 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-2441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578681532 | Shirin Shenasi Azari | Psychologist | 1601 Dove St Ste 185, Newport Beach, CA 92660-2441 | 2007-03-27 |
| 1184990087 | Charles Chaney | Psychiatry & Neurology | 1601 Dove St Ste 185, Newport Beach, CA 92660-2441 | 2012-03-26 |
| 1306131008 | Victor Lee | Chiropractor | 1601 Dove St Ste 185, Newport Beach, CA 92660-2441 | 2011-06-10 |
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|---|---|---|---|---|
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| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
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| 1952857336 | Eating Disorder Center of California | Clinic/Center | 2 Corporate Plaza Dr, Suite 200, Newport Beach, CA 92660-7929 | 2016-08-26 |
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| 1962016527 | Los Angeles County Department of Mental Health | Clinic/Center | 2934 E Garvey Ave South Ste 230, West Covina, CA 91791-6101 | 2020-09-01 |
| 1649883828 | Soul Solutions, LLC | Clinic/Center | 5100 N 6th St Ste 148, Fresno, CA 93710-7514 | 2020-08-26 |
| Find all providers with the same taxonomy | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.