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General NPI Number Information
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NPI Number | 1033879382
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Entity Type | Organization
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Legal Business Name | A WEB OF WELLNESS
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Dates
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Enumeration Date | 12/28/2021
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 3411 1/2 W 43RD PL STE 105
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City | LOS ANGELES
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State | CA
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Zip | 90008-4907
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Country | US
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Telephone | 323-310-3635
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Fax |
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Provider Business Mailing Address
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Address Line | 3411 1/2 W 43RD PL STE 105
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City | LOS ANGELES
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State | CA
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Zip | 90008-4907
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Country | US
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Telephone | 323-310-3635
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Fax |
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Authorized Official
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Title or Position | PRACTITIONER
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Name | KADIATOU SIBI
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Credential |
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Telephone | 323-301-3635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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