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General NPI Number Information
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NPI Number | 1760202873
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Entity Type | Organization
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Legal Business Name | THE WELLNESS INSTITUTE
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 3252 HOLIDAY CT STE 211
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City | LA JOLLA
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State | CA
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Zip | 92037-0027
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Country | US
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Telephone | 844-384-2476
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Fax | 844-384-2476
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Provider Business Mailing Address
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Address Line | 5565 GROSSMONT CENTER DR STE 256
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City | LA MESA
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State | CA
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Zip | 91942-3098
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Country | US
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Telephone | 844-384-2476
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Fax | 844-384-2476
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | WILL ALVAREZ
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Credential |
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Telephone | 844-384-2476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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