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General NPI Number Information
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NPI Number | 1720973225
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Entity Type | Organization
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Legal Business Name | CABANA WELLNESS, INC.
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 2346 WESTWOOD BLVD STE 5
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City | LOS ANGELES
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State | CA
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Zip | 90064-2125
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Country | US
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Telephone | 408-394-5435
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Fax |
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Provider Business Mailing Address
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Address Line | 11301 W OLYMPIC BLVD # 121364
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City | LOS ANGELES
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State | CA
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Zip | 90064-1653
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Country | US
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Telephone | 408-394-5435
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JUSTIN CABANA
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Credential |
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Telephone | 408-394-5435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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