Provider Demographics
NPI:1780551416
Name:TIANA THERAPEUTIC BODYWORK
Entity type:Organization
Organization Name:TIANA THERAPEUTIC BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:BIBISH ONJEME
Authorized Official - Last Name:ELAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-818-6014
Mailing Address - Street 1:5312 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-3530
Mailing Address - Country:US
Mailing Address - Phone:310-818-6014
Mailing Address - Fax:
Practice Address - Street 1:5312 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-3530
Practice Address - Country:US
Practice Address - Phone:310-818-6014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty