Provider Demographics
NPI:1720528722
Name:WARRIOR WELLNESS INC
Entity Type:Organization
Organization Name:WARRIOR WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:MORENO
Authorized Official - Last Name:HURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-672-4049
Mailing Address - Street 1:843 SAN BENITO ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4878
Mailing Address - Country:US
Mailing Address - Phone:831-630-5754
Mailing Address - Fax:831-630-5786
Practice Address - Street 1:930 SUNNYSLOPE RD
Practice Address - Street 2:SUITE A4
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5615
Practice Address - Country:US
Practice Address - Phone:831-630-5754
Practice Address - Fax:831-630-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3988926207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty