| Defiant Health | |
|
1338 Carlotta Avenue Berkley CA 94703 | |
| (415) 307-3302 | |
| Not Available |
| Full Name | Defiant Health |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1338 Carlotta Avenue, Berkley, California |
| Authorized Official Name and Position | Walt Cooper (CEO) |
| Authorized Official Contact | 7194661661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Defiant Health 68 Harrison Ave Ste 605 Boston MA 02111-1929 Ph: (415) 307-3302 | Defiant Health 1338 Carlotta Avenue Berkley CA 94703 Ph: (415) 307-3302 |
| NPI Number | 1518770874 |
|---|---|
| Provider Enumeration Date | 01/30/2025 |
| Last Update Date | 02/05/2025 |
| Certification Date | 02/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518770874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |