NPI 1184430696

Innerbloom Ketamine Therapy

Organisation Integrative Medicine Physician San Luis Obispo, CA

Practice location

Address: 100 Casa St STE D3, San Luis Obispo, CA 93405-5827
Phone: (805) 321-8471
Fax: (805) 567-6604

Authorised official

Name: Ray Rivas
Title: MD
Phone: (805) 321-8471

Registered specialties

Integrative Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 202D00000X

Other Integrative Medicine providers in California →

Registry record

NPI: 1184430696
Entity type: Organization
NPI issued: 9 Dec 2024
Record last updated: 3 Mar 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.