Provider Demographics
NPI:1891396347
Name:BIEN WELLNESS INC
Entity Type:Organization
Organization Name:BIEN WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTERATOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHSEREJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-376-6804
Mailing Address - Street 1:15508 S NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4014
Mailing Address - Country:US
Mailing Address - Phone:310-523-3747
Mailing Address - Fax:
Practice Address - Street 1:15508 S NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4014
Practice Address - Country:US
Practice Address - Phone:310-523-3747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty