Healthcare Provider Details

I. General information

NPI: 1144124819
Provider Name (Legal Business Name): WELLNESS WORLD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 E 215TH PL
CARSON CA
90745-1603
US

IV. Provider business mailing address

1119 E 215TH PL
CARSON CA
90745-1603
US

V. Phone/Fax

Practice location:
  • Phone: 213-568-7298
  • Fax:
Mailing address:
  • Phone: 213-568-7298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. ELIZABETH GOMEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 213-568-7298