Healthcare Provider Details

I. General information

NPI: 1821348541
Provider Name (Legal Business Name): LIVE RIGHT WELLNESS CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16730 BERNARDO CENTER DR
SAN DIEGO CA
92128-5510
US

IV. Provider business mailing address

16730 BERNARDO CENTER DR
SAN DIEGO CA
92128-5510
US

V. Phone/Fax

Practice location:
  • Phone: 858-676-1166
  • Fax: 858-676-1172
Mailing address:
  • Phone: 858-676-1166
  • Fax: 858-676-1172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES LAWRENCE PADILLA
Title or Position: DIRECTOR
Credential: D.C.
Phone: 858-676-1166