Provider Demographics
NPI:1245043512
Name:LIVE WELL COLLECTIVE
Entity type:Organization
Organization Name:LIVE WELL COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER/ FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:WELL
Authorized Official - Last Name:BENDINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:858-344-8249
Mailing Address - Street 1:742 GENEVIEVE ST STE B
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2060
Mailing Address - Country:US
Mailing Address - Phone:858-263-5955
Mailing Address - Fax:
Practice Address - Street 1:742 GENEVIEVE ST STE B
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2060
Practice Address - Country:US
Practice Address - Phone:858-263-5955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty