Healthcare Provider Details

I. General information

NPI: 1932971744
Provider Name (Legal Business Name): WELCOME NIGHTS INNOVATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 MARKET ST STE D
CONCORD CA
94520-2618
US

IV. Provider business mailing address

1950 MARKET ST STE D
CONCORD CA
94520-2618
US

V. Phone/Fax

Practice location:
  • Phone: 510-221-8541
  • Fax:
Mailing address:
  • Phone: 510-221-8541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHUL DOKKO
Title or Position: PRESIDENT
Credential:
Phone: 510-221-8541