Provider Demographics
NPI:1033879382
Name:A WEB OF WELLNESS
Entity Type:Organization
Organization Name:A WEB OF WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KADIATOU
Authorized Official - Middle Name:
Authorized Official - Last Name:SIBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-301-3635
Mailing Address - Street 1:3411 1/2 W 43RD PL STE 105
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4907
Mailing Address - Country:US
Mailing Address - Phone:323-310-3635
Mailing Address - Fax:
Practice Address - Street 1:3411 1/2 W 43RD PL STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-4907
Practice Address - Country:US
Practice Address - Phone:323-310-3635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0OtherDONT HAVE