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General NPI Number Information
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NPI Number | 1942556519
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Entity Type | Organization
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Legal Business Name | WELLNESS CENTER A MEDICAL CLINIC INC
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 23560 CRENSHAW BLVD 104
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City | TORRANCE
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State | CA
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Zip | 90505-5233
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Country | US
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Telephone | 214-842-3351
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60790
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City | PASADENA
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State | CA
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Zip | 91116-6790
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Country | US
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Telephone | 214-842-3351
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID H RAHM
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Credential | M.D.
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Telephone | 214-842-3351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G56938
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License Number State | CA
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