| Wellness & Equity Foundation Inc. | |
|
969 E 12th St Ste D Los Angeles CA 90021-2201 | |
| (408) 341-9606 | |
| Not Available |
| Full Name | Wellness & Equity Foundation Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 969 E 12th St Ste D, Los Angeles, California |
| Authorized Official Name and Position | William Randall (MANAGER OF STRATEGIC INITIATIVES) |
| Authorized Official Contact | 9135485987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness & Equity Foundation Inc. 250 Quail Ridge Rd Scotts Valley CA 95066-4821 Ph: (917) 648-1068 | Wellness & Equity Foundation Inc. 969 E 12th St Ste D Los Angeles CA 90021-2201 Ph: (408) 341-9606 |
| NPI Number | 1043059348 |
|---|---|
| Provider Enumeration Date | 05/24/2024 |
| Last Update Date | 07/02/2024 |
| Certification Date | 07/02/2024 |
| Medicare PECOS PAC ID | 3971032483 |
|---|---|
| Medicare Enrollment ID | O20250129001326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043059348 | NPI | - | NPPES |
| Provider Name | Tyler Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912227125 PECOS PAC ID: 9335311059 Enrollment ID: I20240928000255 |
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