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General NPI Number Information
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NPI Number | 1821975459
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Entity Type | Organization
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Legal Business Name | HYDRAFIT WELLNESS, LLC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 2741 CHOPIN AVE
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City | SAN JOSE
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State | CA
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Zip | 95122-1310
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Country | US
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Telephone | 408-230-7679
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Fax |
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Provider Business Mailing Address
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Address Line | 3277 S WHITE RD # 228
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City | SAN JOSE
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State | CA
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Zip | 95148-4056
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Country | US
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Telephone | 408-230-7679
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Fax |
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Authorized Official
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Title or Position | OWNER & CEO
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Name | ARDEN A PHAN
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Credential | RN
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Telephone | 408-230-7679
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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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 | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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