Healthcare Provider Details

I. General information

NPI: 1659163970
Provider Name (Legal Business Name): KELHEALTHANDWELLNESS MED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21250 HAWTHORNE BLVD STE 500
TORRANCE CA
90503-5514
US

IV. Provider business mailing address

21250 HAWTHORNE BLVD STE 500
TORRANCE CA
90503-5514
US

V. Phone/Fax

Practice location:
  • Phone: 626-768-2649
  • Fax: 626-995-1540
Mailing address:
  • Phone: 626-768-2649
  • Fax: 626-995-1540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: KELECHI OKWARAJI
Title or Position: PARTNER
Credential: NP
Phone: 206-456-6933