Provider Demographics
NPI:1780190983
Name:THRIVE FULL BODY WELLNESS
Entity Type:Organization
Organization Name:THRIVE FULL BODY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-952-9335
Mailing Address - Street 1:4959 KATELLA AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2747
Mailing Address - Country:US
Mailing Address - Phone:714-952-9335
Mailing Address - Fax:714-952-9331
Practice Address - Street 1:4959 KATELLA AVE STE C
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90720-2747
Practice Address - Country:US
Practice Address - Phone:714-952-9335
Practice Address - Fax:714-952-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty