Healthcare Provider Details

I. General information

NPI: 1396475497
Provider Name (Legal Business Name): TOTAL HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27355 JEFFERSON AVE STE A
TEMECULA CA
92590-5606
US

IV. Provider business mailing address

27355 JEFFERSON AVE STE A
TEMECULA CA
92590-5606
US

V. Phone/Fax

Practice location:
  • Phone: 858-366-3386
  • Fax:
Mailing address:
  • Phone: 858-366-3386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: TAWAB SIDDIQUI
Title or Position: CEO
Credential:
Phone: 858-366-3386