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General NPI Number Information
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NPI Number | 1184922429
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Entity Type | Organization
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Legal Business Name | THE WELLNESS INSTITUTE OF AMERICA, LLC
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 2425 CAMINO DEL RIO S SUITE 150
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City | SAN DIEGO
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State | CA
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Zip | 92108-3744
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Country | US
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Telephone | 619-265-0291
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Fax | 619-265-0290
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Provider Business Mailing Address
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Address Line | 2425 CAMINO DEL RIO S SUITE 150
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City | SAN DIEGO
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State | CA
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Zip | 92108-3744
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Country | US
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Telephone | 619-265-0291
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Fax | 619-265-0290
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. MARC BENJAMIN SKLAR
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Credential | LAC
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Telephone | 619-265-0291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 9332
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License Number State | CA
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