Provider Demographics
NPI:1023461555
Name:FORTE WELLNESS INC
Entity type:Organization
Organization Name:FORTE WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:III
Authorized Official - Credentials:D C
Authorized Official - Phone:626-698-8784
Mailing Address - Street 1:1028 N. LAKE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-4570
Mailing Address - Country:US
Mailing Address - Phone:626-698-8784
Mailing Address - Fax:626-389-8994
Practice Address - Street 1:1028 N. LAKE AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-4570
Practice Address - Country:US
Practice Address - Phone:626-698-8784
Practice Address - Fax:626-389-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty