Healthcare Provider Details

I. General information

NPI: 1821704149
Provider Name (Legal Business Name): ROBERTSON WELLNESS CONCIERGE SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N ROBERTSON BLVD STE 206
BEVERLY HILLS CA
90211-2144
US

IV. Provider business mailing address

150 N ROBERTSON BLVD STE 206
BEVERLY HILLS CA
90211-2144
US

V. Phone/Fax

Practice location:
  • Phone: 310-407-0542
  • Fax:
Mailing address:
  • Phone: 310-407-0542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BIANA KRAYEVSKY
Title or Position: OWNER
Credential: NP
Phone: 323-627-1557