Provider Demographics
NPI:1043758014
Name:INNER QI WELLNESS INC
Entity Type:Organization
Organization Name:INNER QI WELLNESS INC
Other - Org Name:INNER QI CHIROPRACTIC & ACUPUNCTURE WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THALES
Authorized Official - Middle Name:SAIKI
Authorized Official - Last Name:RUELA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:951-428-4135
Mailing Address - Street 1:710 RIMPAU AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-5724
Mailing Address - Country:US
Mailing Address - Phone:951-428-4135
Mailing Address - Fax:951-339-3623
Practice Address - Street 1:710 RIMPAU AVE STE 106
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-5724
Practice Address - Country:US
Practice Address - Phone:951-428-4135
Practice Address - Fax:951-339-3623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC32763111N00000X
CAAC15255171100000X
CAAC15916171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1043758014OtherNPI TYPE 2