Integrative Wellness Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

104552 Issued in CA

Legal business name

INTEGRATIVE WELLNESS MEDICAL GROUP

Practice address

125 N Acacia Ave
Suite 111
Solana Beach, CA 92075-1165

Phone

(858) 444-0111

Fax

(858) 794-2722

NPI assigned

May 3, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kerrin Moote

Title

Office Manager

Phone

(858) 444-0111

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn Barry Frieder, DC

  • Chiropractor
  • Solana Beach, CA
  • NPI 1003023839
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1609211648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N ACACIA",
            "address_2": "SUITE 111",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "92075",
            "telephone_number": "858-444-0111",
            "fax_number": "858-794-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N ACACIA AVE",
            "address_2": "SUITE 111",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751165",
            "telephone_number": "858-444-0111",
            "fax_number": "858-794-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE WELLNESS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "MOOTE",
        "authorized_official_first_name": "KERRIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "858-444-0111"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "CA30803",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "104552",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A96446",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A104552",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hydo, Angelopoulos & Miller Dental Group
• Christopher S Hydo, DDS, MS
• Hyo Bae PHD
• Indihill Group, Inc.
• Inner Healing Center, Inc.
• Ioana M Swikard OD a Professional Corporation
• Sarah Marie Isdaner, PT, DPT
• Jeffrey Alan Iverson, FNP
• Susan Iyican, PH.D.
• Blaine Kenton Jackson, M.D.

• Family Medicine Physician in Solana Beach, CA
• Providers in Solana Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.