DRAGONFLY HOLDING LLC (NPI# 1982175345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982175345 |
| Entity Type | Organization |
| Organization Name | DRAGONFLY HOLDING LLC |
| Other Organization Name | CLEAR MIND TREATMENT |
| Practice Address |
3200 Santa Monica Blvd Ste 204 Santa Monica CA 90404-2639 |
| Mailing Address |
1700 Curtis Ave Manhattan Beach CA 90266-7025 |
| Practice Telephone | 3105715957 |
| Mailing Telephone | 3105715957 |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2019-06-17 |
| Authorized Official Name | RISHI KHATRI (CEO) |
| Authorized Official Telephone | 3105715957 |
| Is Organization Subpart | Y |
| Parent Organization Name | KEN STARR MD WELLNESS GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Clear Mind Treatment | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 107 Nelson St, Arroyo Grande, CA 934203318 | 3105715957 | |
| 1700 Curtis Ave, Manhattan Beach, CA 902667025 | 3108965183 |
| Street Address |
3200 SANTA MONICA BLVD STE 204 |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90404-2639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316097710 | Jamal Mahboob | Dentist | 3200 Santa Monica Blvd Ste 204, Santa Monica, CA 90404-2639 | 2007-01-11 |
| 1366052391 | Bespoke Treatment LLC | Clinic/Center | 3200 Santa Monica Blvd Ste 204, Santa Monica, CA 90404-2639 | 2020-08-04 |
| 1417584244 | Dragonfly Medical | Internal Medicine | 3200 Santa Monica Blvd Ste 204, Santa Monica, CA 90404-2639 | 2020-03-23 |
| 1437471067 | Meredith Sagan, Md, A Professional Corporation | Community/Behavioral Health | 3200 Santa Monica Blvd Ste 204, Santa Monica, CA 90404-2639 | 2010-02-23 |
| 1609097088 | Meredith Sagan | Psychiatry & Neurology | 3200 Santa Monica Blvd Ste 204, Santa Monica, CA 90404-2639 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453352 | Jasmine Burton | Physical Therapist | 1714 17th Street, Santa Monica, CA 90404 | 2020-09-24 |
| 1003431685 | Cintia Haydee Ctibor | Behavior Technician | 1869 9th Street, Santa Monica, CA 90404 | 2020-06-10 |
| 1073137261 | Sydney Kristine Valerio | Counselor | 1869 9th St, Santa Monica, CA 90404 | 2020-06-03 |
| 1710507082 | James Gilbert Cunningham | Marriage & Family Therapist | 1708 Olympic Blvd, Santa Monica, CA 90404 | 2020-04-16 |
| 1841763687 | Crystal Monique Mckinley X | Counselor | 1865 9th St, Santa Monica, CA 90404 | 2019-01-04 |
| 1952872749 | Cesar O Munoz | Licensed Vocational Nurse | 1865 9th St., Santa Monica, CA 90404 | 2018-12-06 |
| 1023596574 | Joseph J Pinzone Md Inc | Internal Medicine | 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 | 2018-08-06 |
| 1548763535 | Alan Rubenstein Dds Inc | Dentist | 1260 15th St., #703, Santa Monica, CA 90404 | 2018-03-15 |
| 1669993382 | Aaron Wilson | Counselor | 1453 16th Street, Santa Monica, CA 90404 | 2017-07-03 |
| 1922472471 | Chianni Lin | Acupuncturist | 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 | 2015-11-20 |
| Find all providers in zip 90404 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184110678 | Alavida Usa | Clinic/Center | 2500 Broadway Ste F125, Santa Monica, CA 90404-3080 | 2018-07-08 |
| 1316320047 | Rylist Inc. | Clinic/Center | 1243 7th St, Suite B, Santa Monica, CA 90401 | 2015-06-30 |
| 1013396076 | Thrive Treatment LLC | Clinic/Center | 3101 Ocean Park Blvd, #309, Santa Monica, CA 90405-3022 | 2015-05-23 |
| 1780011569 | Clare Matrix | Clinic/Center | 1334 Lincoln Blvd, Santa Monica, CA 90401-1730 | 2013-10-10 |
| 1871868414 | Clare Foundation, Inc. | Clinic/Center | 1334 Lincoln Blvd, Santa Monica, CA 90401 | 2012-03-15 |
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| 1003427337 | Restorative Partners, Inc. | Clinic/Center | 3220 S Higuera St Ste 103a, San Luis Obispo, CA 93401-2023 | 2020-08-11 |
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| 1104435734 | New Life Health Authority / Dba New Life LLC | Clinic/Center | 280 E Standley St, Ukiah, CA 95482-4414 | 2020-07-29 |
| 1043829971 | House of Hope Foundation Inc | Clinic/Center | 227 W 9th St, San Pedro, CA 90731-3711 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | SANTA MONICA |
| Zip Code | 90404 |
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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.