Provider Demographics
NPI:1447068721
Name:HOPE HEADACHE CLINIC CORP
Entity type:Organization
Organization Name:HOPE HEADACHE CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:NANNETTE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:562-213-3046
Mailing Address - Street 1:1023 STEELE DR
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-2232
Mailing Address - Country:US
Mailing Address - Phone:562-213-3046
Mailing Address - Fax:
Practice Address - Street 1:1023 STEELE DR
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-2232
Practice Address - Country:US
Practice Address - Phone:562-213-3046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty