Provider Demographics
NPI:1871250563
Name:HEAL DOCTORS IHWA, P.C.
Entity Type:Organization
Organization Name:HEAL DOCTORS IHWA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:844-403-4325
Mailing Address - Street 1:11301 W. OLYMPIC BLVD
Mailing Address - Street 2:STE 121-PMB 662
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 KNIGHTSBRIDGE ROAD
Practice Address - Street 2:STE 525
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3948
Practice Address - Country:US
Practice Address - Phone:844-403-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty