Provider Demographics
NPI:1326681560
Name:STRATEGIC WELLNESS INC
Entity Type:Organization
Organization Name:STRATEGIC WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:NIENOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-833-2002
Mailing Address - Street 1:2300 CALIFORNIA ST STE 306
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2754
Mailing Address - Country:US
Mailing Address - Phone:415-202-1550
Mailing Address - Fax:415-776-8233
Practice Address - Street 1:2300 CALIFORNIA ST STE 306
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2754
Practice Address - Country:US
Practice Address - Phone:415-202-1550
Practice Address - Fax:415-776-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty