Healthcare Provider Details

I. General information

NPI: 1841002409
Provider Name (Legal Business Name): BWY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9454 WILSHIRE BLVD STE 600
BEVERLY HILLS CA
90212-2980
US

IV. Provider business mailing address

325 N MAPLE DR UNIT 14
BEVERLY HILLS CA
90213-4801
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-1828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BIN YANG
Title or Position: PRESIDENT
Credential: MD
Phone: 310-668-1828