Healthcare Provider Details

I. General information

NPI: 1376300228
Provider Name (Legal Business Name): ONE STOP WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N BELLFLOWER BLVD STE 201
LONG BEACH CA
90815-1144
US

IV. Provider business mailing address

2700 N BELLFLOWER BLVD STE 201
LONG BEACH CA
90815-1144
US

V. Phone/Fax

Practice location:
  • Phone: 562-888-3399
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREI DOKUKIN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 562-888-3399