Healthcare Provider Details
I. General information
NPI: 1831979657
Provider Name (Legal Business Name): WHOLE PERSON CARE MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2023
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 N ASH ST
ESCONDIDO CA
92027-3058
US
IV. Provider business mailing address
120 N ASH ST
ESCONDIDO CA
92027-3058
US
V. Phone/Fax
- Phone: 760-385-3739
- Fax: 888-800-8226
- Phone: 760-385-3739
- Fax: 888-800-8226
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JENNIFER
PAMELA
COHEN
Title or Position: CEO
Credential: MD
Phone: 858-822-8773