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General NPI Number Information
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NPI Number | 1982403572
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Entity Type | Organization
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Legal Business Name | OPENWELL MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 2384 GALBRETH RD
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City | PASADENA
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State | CA
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Zip | 91104-3431
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Country | US
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Telephone | 559-977-7591
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 E COLORADO BLVD # 4030
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City | PASADENA
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State | CA
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Zip | 91106-1932
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. JONATHAN RICHINA
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Credential | MD
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Telephone | 559-977-7591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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