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General NPI Number Information
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NPI Number | 1194100156
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Entity Type | Organization
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Legal Business Name | WELL NOW PHYSICIANS PC
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Dates
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Enumeration Date | 07/20/2015
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Last Update Date | 07/20/2015
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Provider Practice Location Address
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Address Line | 1590 ROSECRANS AVE STE D302
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-3727
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Country | US
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Telephone | 424-262-4485
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 ROSECRANS AVE STE D302
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-3727
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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 | PRESIDENT
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Name | DR. MICHAEL TARNAY
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Credential | M.D.
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Telephone | 424-262-4485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A061548
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License Number State | CA
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