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General NPI Number Information
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NPI Number | 1356523120
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Entity Type | Organization
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Legal Business Name | TOTAL WELLNESS MEDICAL CORP
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 27405 PUERTA REAL STE 200
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6314
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Country | US
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Telephone | 949-273-6663
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Fax |
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Provider Business Mailing Address
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Address Line | 27405 PUERTA REAL STE 200
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6314
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Country | US
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Telephone | 949-273-6663
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | CHERYL A THOMAS
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Credential | M.D.
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Telephone | 949-836-5145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G066547
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License Number State | CA
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