| Healwell Management LLC | |
|
640 S San Vicente Blvd Ste 442 Los Angeles CA 90048-4654 | |
| (747) 230-9878 | |
| Not Available |
| Full Name | Healwell Management LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 640 S San Vicente Blvd Ste 442, Los Angeles, California |
| Authorized Official Name and Position | Thulasi Kiran Kamasani (CEO) |
| Authorized Official Contact | 3129094578 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healwell Management LLC 640 S San Vicente Blvd Ste 442 Los Angeles CA 90048-4654 Ph: (747) 230-9878 | Healwell Management LLC 640 S San Vicente Blvd Ste 442 Los Angeles CA 90048-4654 Ph: (747) 230-9878 |
| NPI Number | 1952278905 |
|---|---|
| Provider Enumeration Date | 10/22/2025 |
| Last Update Date | 10/22/2025 |
| Certification Date | 10/22/2025 |
| Medicare PECOS PAC ID | 6103395686 |
|---|---|
| Medicare Enrollment ID | O20260513004162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952278905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Sevara Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770028409 PECOS PAC ID: 5799114906 Enrollment ID: I20240809003575 |
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