Healthcare Provider Details

I. General information

NPI: 1417530627
Provider Name (Legal Business Name): RJ WELLNESS CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3756 WEST AVE 40 STE 2B
LOS ANGELES CA
90065-3667
US

IV. Provider business mailing address

9446 RALPH ST
ROSEMEAD CA
91770-2111
US

V. Phone/Fax

Practice location:
  • Phone: 323-880-9938
  • Fax:
Mailing address:
  • Phone: 323-880-9938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNY GADIA
Title or Position: MANAGER
Credential: PHYSICAL THERAPIST
Phone: 323-880-9938