Provider Demographics
NPI:1639687650
Name:WELL4WORK
Entity Type:Organization
Organization Name:WELL4WORK
Other - Org Name:WELL4WORK CALIFORNIA, APC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-224-4600
Mailing Address - Street 1:5321 N FRESNO ST STE 105C
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6850
Mailing Address - Country:US
Mailing Address - Phone:559-224-4600
Mailing Address - Fax:559-228-4040
Practice Address - Street 1:5321 N FRESNO ST STE 105C
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6850
Practice Address - Country:US
Practice Address - Phone:559-224-4600
Practice Address - Fax:559-228-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty