Provider Demographics
NPI:1114104536
Name:A CENTER FOR WELLNESS
Entity Type:Organization
Organization Name:A CENTER FOR WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-653-4826
Mailing Address - Street 1:8222 MELROSE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6825
Mailing Address - Country:US
Mailing Address - Phone:323-653-4826
Mailing Address - Fax:323-653-0216
Practice Address - Street 1:8222 MELROSE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-6825
Practice Address - Country:US
Practice Address - Phone:323-653-4826
Practice Address - Fax:323-653-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty