Provider Demographics
NPI:1932456837
Name:EMW CENTER FOR HOLISTIC MEDICINE
Entity Type:Organization
Organization Name:EMW CENTER FOR HOLISTIC MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:POLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-936-8512
Mailing Address - Street 1:5820 WILSHIRE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4581
Mailing Address - Country:US
Mailing Address - Phone:323-936-8512
Mailing Address - Fax:
Practice Address - Street 1:5820 WILSHIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4581
Practice Address - Country:US
Practice Address - Phone:323-936-8512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6293171100000X
CA261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty