Innerbloom Ketamine Therapy
Innerbloom Ketamine Therapy is an Integrative Medicine Physician in San Luis Obispo, California. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
100 Casa St Ste D3San Luis Obispo, CA 93405-5827
Phone: (805) 321-8471
Fax: (805) 567-6604
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Specialties & licences
| Integrative Medicine Physician (primary) | Taxonomy 202D00000X |
|---|
Record details
| NPI number | 1184430696 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ray Rivas — Md · (805) 321-8471 |
| NPI enumerated | December 9, 2024 |
| Last updated in NPPES | March 3, 2026 |
| Certification date | March 3, 2026 |
| Mailing address | 100 Casa St Ste D3, San Luis Obispo, CA 93405-5827 |