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General NPI Number Information
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NPI Number | 1649141706
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Entity Type | Organization
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Legal Business Name | WELLNESS OF MIND BODY AND SPIRIT LLC
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Dates
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Enumeration Date | 09/13/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 842 E MISSION RD STE C
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City | SAN GABRIEL
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State | CA
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Zip | 91776-2761
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Country | US
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Telephone | 626-571-8660
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Fax | 844-270-2240
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Provider Business Mailing Address
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Address Line | 418 E LAS TUNAS DR UNIT 3G
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City | SAN GABRIEL
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State | CA
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Zip | 91776-5506
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Country | US
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Telephone | 626-571-8660
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Fax | 844-270-2240
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Authorized Official
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Title or Position | ELECTROLOGIST/MANAGER
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Name | MS. ANA HUA
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Credential |
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Telephone | 626-571-8660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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