Provider Demographics
NPI:1043624679
Name:THE ADVANI CENTER FOR INTEGRATIVE WELLNESS AND HEALING, INC
Entity Type:Organization
Organization Name:THE ADVANI CENTER FOR INTEGRATIVE WELLNESS AND HEALING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADVANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-463-8323
Mailing Address - Street 1:550 S BARRINGTON AVE
Mailing Address - Street 2:UNIT 1112
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-4333
Mailing Address - Country:US
Mailing Address - Phone:310-463-8323
Mailing Address - Fax:
Practice Address - Street 1:1526 14TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3320
Practice Address - Country:US
Practice Address - Phone:310-463-8323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12257171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty