Provider Demographics
NPI:1376205971
Name:PRIORITY WELLNESS SERVICES PC
Entity Type:Organization
Organization Name:PRIORITY WELLNESS SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-878-6027
Mailing Address - Street 1:2525 N GRAND AVE STE J
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8726
Mailing Address - Country:US
Mailing Address - Phone:714-878-6027
Mailing Address - Fax:
Practice Address - Street 1:2525 N GRAND AVE STE J
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8726
Practice Address - Country:US
Practice Address - Phone:714-878-6027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy