Healthcare Provider Details

I. General information

NPI: 1326681560
Provider Name (Legal Business Name): STRATEGIC WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CALIFORNIA ST STE 306
SAN FRANCISCO CA
94115-2754
US

IV. Provider business mailing address

2300 CALIFORNIA ST STE 306
SAN FRANCISCO CA
94115-2754
US

V. Phone/Fax

Practice location:
  • Phone: 415-202-1550
  • Fax: 415-776-8233
Mailing address:
  • Phone: 415-202-1550
  • Fax: 415-776-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN R NIENOW
Title or Position: OWNER
Credential: MD
Phone: 916-833-2002