Healthcare Provider Details

I. General information

NPI: 1306344981
Provider Name (Legal Business Name): A I M FOR WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 LA TIJERA BLVD
LOS ANGELES CA
90045
US

IV. Provider business mailing address

8725 LA TIJERA BLVD
LOS ANGELES CA
90045-3906
US

V. Phone/Fax

Practice location:
  • Phone: 424-331-5661
  • Fax: 310-760-2033
Mailing address:
  • Phone: 424-331-5661
  • Fax: 310-760-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: RAMONA G COLBERT
Title or Position: MANAGER
Credential: L.AC.
Phone: 424-331-5661