Healthcare Provider Details

I. General information

NPI: 1417768680
Provider Name (Legal Business Name): ANJEL WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 WILSHIRE BLVD STE 313
BEVERLY HILLS CA
90210-6131
US

IV. Provider business mailing address

6522 W 6TH ST
LOS ANGELES CA
90048-4716
US

V. Phone/Fax

Practice location:
  • Phone: 310-299-6643
  • Fax: 760-797-1845
Mailing address:
  • Phone: 310-299-6643
  • Fax: 760-797-1845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: ANJEL KHOUBIAN
Title or Position: OFFICER/ACUPUNCTURIST
Credential: LAC
Phone: 310-299-6643