MEDICARE: ELEMENTS OF WELLNESS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor

General Provider Information

NPI Number	:	1497317762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEMENTS OF WELLNESS INC

Provider Business Mailing Address
First Line	:	3535 CAHUENGA BLVD W STE 206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1359
Country	:	US
Telephone Number	:	323-600-4303
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 CAHUENGA BLVD W STE 206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1359
Country	:	US
Telephone Number	:	323-600-4303
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	DR. CHETT MALLETT
Credential	:	D.C.
Telephone Number	:	323-600-4303

Provider Enumeration Date	:	07/07/2019
Last Update Date	:	07/07/2019

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Directions to “ELEMENTS OF WELLNESS INC ” Practice Location

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