Healthcare Provider Details

I. General information

NPI: 1366297780
Provider Name (Legal Business Name): INFINITY WELLNESS INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 02/15/2025
Certification Date: 02/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10780 SANTA MONICA BLVD STE 350
LOS ANGELES CA
90025-4779
US

IV. Provider business mailing address

10780 SANTA MONICA BLVD STE 350
LOS ANGELES CA
90025-4779
US

V. Phone/Fax

Practice location:
  • Phone: 424-274-1550
  • Fax: 920-352-4156
Mailing address:
  • Phone: 424-274-1550
  • Fax: 920-352-4156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ISABELLA LAI
Title or Position: PRESIDENT
Credential: MD
Phone: 714-366-5066