Healthcare Provider Details

I. General information

NPI: 1518874569
Provider Name (Legal Business Name): WELLNESS 90210
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N BEDFORD DR STE 411
BEVERLY HILLS CA
90210-4340
US

IV. Provider business mailing address

435 N BEDFORD DR STE 411
BEVERLY HILLS CA
90210-4340
US

V. Phone/Fax

Practice location:
  • Phone: 424-339-0210
  • Fax:
Mailing address:
  • Phone: 424-339-0210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERWIN HARIRI
Title or Position: PRESIDENT
Credential: MD
Phone: 310-739-5949