| Wise &healthy Aging | |
|
1527 4th St 3rd Floor Santa Monica CA 90401-2358 | |
| (310) 394-9871 | |
| (310) 576-2499 |
| Full Name | Wise &healthy Aging |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1527 4th St, Santa Monica, California |
| Authorized Official Name and Position | Grace Cheng Braun (PRESIDENT & CEO) |
| Authorized Official Contact | 3103949871 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise &healthy Aging 1527 4th St 2nd Floor Santa Monica CA 90401-2358 Ph: (310) 394-9871 | Wise &healthy Aging 1527 4th St 3rd Floor Santa Monica CA 90401-2358 Ph: (310) 394-9871 |
| NPI Number | 1134399165 |
|---|---|
| Provider Enumeration Date | 03/05/2008 |
| Last Update Date | 09/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134399165 | NPI | - | NPPES |
| W13662 | Other | CA | MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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