Healthcare Provider Details

I. General information

NPI: 1861348898
Provider Name (Legal Business Name): INDIGENOUS HEALTHCARE ADVANCEMENTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 W TEMPLE ST STE 3036
LOS ANGELES CA
90026-7335
US

IV. Provider business mailing address

1711 W TEMPLE ST STE 3036
LOS ANGELES CA
90026-7335
US

V. Phone/Fax

Practice location:
  • Phone: 213-989-6114
  • Fax: 213-484-3552
Mailing address:
  • Phone: 213-989-6114
  • Fax: 213-484-3552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: PUI REEVES
Title or Position: MANAGER
Credential:
Phone: 808-214-7269