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General NPI Number Information
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NPI Number | 1366764136
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Entity Type | Organization
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Legal Business Name | ALL AS WELL CORP.
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 57725 29 PALMS HWY #401
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City | YUCCA VALLEY
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State | CA
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Zip | 92284
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Country | US
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Telephone | 310-756-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 18058 ESPITO STREET
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City | ROWLAND HTS.
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State | CA
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Zip | 91748
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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 | APRIL FAN
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Credential |
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Telephone | 310-464-1000
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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 | 19550NP
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License Number State | CA
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