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General NPI Number Information
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NPI Number | 1053150698
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Entity Type | Organization
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Legal Business Name | PROWELLNESS HEALTHCARE INC.
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 8439 WHITE OAK AVE STE 1038439
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0621
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Country | US
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Telephone | 818-532-2222
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Fax | 818-591-7322
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Provider Business Mailing Address
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Address Line | 8439 WHITE OAK AVE STE 1038439
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0621
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Country | US
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Telephone | 818-532-2222
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Fax | 818-591-7322
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Authorized Official
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Title or Position | PRESIDENT
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Name | NENA TONG ARCIAGA
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Credential |
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Telephone | 818-532-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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