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General NPI Number Information
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NPI Number | 1619247160
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Entity Type | Organization
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Legal Business Name | CASCADE WELLNESS CENTER INC
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Dates
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Enumeration Date | 12/30/2011
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 23412 MOULTON PKWY #120
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1732
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Country | US
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Telephone | 949-829-6927
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Fax | 949-829-0221
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Provider Business Mailing Address
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Address Line | 23412 MOULTON PKWY #120
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1732
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Country | US
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Telephone | 949-829-6927
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Fax | 949-829-0221
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Authorized Official
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Title or Position | OWNER
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Name | MARYAM ASSADI
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Credential | D.C.
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Telephone | 949-829-6927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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