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General NPI Number Information
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NPI Number | 1043131162
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Entity Type | Organization
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Legal Business Name | WELLNESS STAR LLC
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 409 E THORNTON AVE APT W202
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City | HEMET
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State | CA
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Zip | 92543-7657
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Country | US
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Telephone | 111-111-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 409 E THORNTON AVE APT W202
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City | HEMET
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State | CA
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Zip | 92543-7657
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | IKECHUKWU NWABUOBI
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Credential |
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Telephone | 909-353-0117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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